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Full text of "Anomalies and curiosities of medicine : being an encyclopedic collection of rare and extraordinary cases, and of the most striking instances of abnormality in all branches of medicine and surgery, derived form an exhaustive research of medical literature from its origin to the present day, abstracted, classified, annotated, and indexed"

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Since the time when man's mind first busied itself with subjects beyond his 
own self-preservation and the satisfaction of his bodily appetites, the anoma- 
lous and curious have been of exceptional and persistent fascination to him ; 
and especially is this true of the construction and functions of the human body. 
Possibly, indeed, it was the anomalous that was largely instrumental in arous- 
ing in the savage the attention, thought, and investigation that were finally to 
develop into the body of organized truth which we now call Science. As by 
the aid of collected experience and careful inference we to-day endeavor to 
pass our vision into the dim twilight w'hence has emerged our civilization, we 
find abundant hint and even evidence of this truth. To the highest type of 
philosophic minds it is the usual and the ordinary that demand investigation 
and explanation. But even to such, no less than to the most naive-minded, 
the strange and exceptional is of absorbing interest, and it is often through 
the extraordinary that the philosopher gets the most searching glimpses into 
the heart of the mystery of the ordinary. Truly it has been said, facts are 
stranger than fiction. In monstrosities and dermoid cysts, for example, we 
seem to catch forl^idden sight of the secret work-room of Xature, and drag 
out into the light the evidences of her clumsiness, and proofs of her lapses of 
skill, — evidences and proofs, moreover, that tell us much of the methods and 
means used by the vital artisan of Life, — the lo'dm, and even the silent 
weaver at work upon the mysterious garment of corporeality. 

" La premiere chose qui s'ojfre d P Homme quand il se regcwde, e'est son corps" 
says Pascal, and looking at the matter more closely we find that it was the 
strange and mysterious things of his body that occupied man's earliest as well 
as much of his later attention. In the beginning, the organs and functions of 
generation, the mysteries of sex, not the routine of digestion or of locomotion, 
stimulated his curiosity, and in them he recognized, as it were, an unseen hand 
reaching down into the world of matter and the workings of bodily organiza- 
tion, and reining them to impersonal service and far-olf ends. All ethnolo- 
gists and students of primitive religion w' ell know the role that has been played 
in primitive society by the genetic instincts. Among the older naturalists, 
such as Pliny and Aristotle, and even in the older historians, whose scope 
included natural as well as civil and political history, the atypic and bizarre, 
and especially the aberrations of form or function of the generative organs, 




caught the eye most quickly. Judging from the records of early writers, 
when Medicine began to struggle toward self-consciousness, it was again the 
same order of facts that was singled out by the attention. The very names 
applied by the early anatomists to many structures so widely separated from 
the organs of generation as were those of the brain, give testimony of the state 
of mind that led to and dominated the practice of dissection. 

In the literature of the past centuries the predominance of the interest in 
the curious is exemplilied in the almost ludicrously monotonous iteration of 
titles, in which the conspicuous words are curiosa, rara, monstruosa, memor- 
abilia, prodigiosa, selecta, exotica, miraculi, lusibus naturae, occultis naturae, 
etc., etc. Even when medical science became more strict, it was largely the 
curious and rare that were thought worthy of chronicling, and not the estab- 
lishment or illustration of the common, or of general principles. With all 
his sovereign sound sense, Ambrose Pare has loaded his book with references 
to impossibly strange, and even mythologic cases. 

In our day the taste seems to be insatiable, and hardly any medical jour- 
nal is Avithout its rare or "unique" case, or one noteworthy chiefly by reason 
of its anomalous features. A curious case is invariably reported, and the inser- 
tion of such a report is generally productive of correspondence and discus- 
sion with the object of finding a parallel for it. 

In view of all this it seems itself a curious fact that there has never been 
any systematic gathering of medical curiosities. It would have been most 
natural that numerous encyclopedias should spring into existence in response 
to such a persistently dominant interest. The forelying volume appears to 
be the first thorough attempt to classify and epitomize the literature of this 
nature. It has been our purpose to briefly summarize and to arrange in order 
the records of the most curious, bizarre, and alinormal cases that are found 
in medical literature of all ages and all languages — a thaumatographia medica. 
It will be readily se^ n that such a collection must have a function far beyond 
the satisfaction of mere curiosity, even if that be stigmatized with the word 
" idle." If, as we believe, reference may here be found to all such cases in 
the literature of Medicine (including Anatomy, Physiology, Surgery, Obstet- 
rics, etc.) as show the most extreme and exceptional departures from the 
ordinary, it follows that the future clinician and investigator must have use 
for a handbook that decides whether his own strange case has already been 
paralleled or excelled. He will thus be aided in determining the truth of 
his statements and the accuracy of his diagnoses. Moreover, to know ex- 
tremes gives directly some knowledge of means, and by implication and 
inference it frequently does more. Rcmarkal)le injuries illustrate to what 
extent tissues and organs may be damaged without resultant death, and tlius 
the surgeon is encouraged to proceed to his operation with greater confidence 
and more definite knowledge as to the issue. If a mad cow may blindly 
play the part of a successful obstetrician with her horns, certainly a skilled 


surgeon may hazard entering the womb with his knife. If large portions 
of an organ, — the lung, a kidney, parts of the liver, or the brain itself, — may 
be lost by accident, and the patient still live, the physician is taught the lesson 
of nil desperandum, and that if possible to arrest disease of these organs before 
their total destruction, the prognosis and treatment thereby acquire new and 
more hopeful phases. 

Directly or indirectly many similar examples have also clear medicolegal 
bearings or suggestions ; in fact, it must be acknowledged that much of the im- 
portance of medical jurisprudence lies in a thorough comprehension of the 
anomalous and rare cases in Medicine. Expert medical testimony has its chief 
value in showing the possibilities of the occurrence of alleged extreme cases, 
and extraordinary deviations from the natural. Every expert witness should 
be able to maintain his argument by a full citation of parallels to any 
remarkable theory or hypothesis advanced by his clients ; and it is only by 
an exhaustive knowledge of extremes and anomalies that an authority on 
medical jurisprudence can hope to substantiate his testimony beyond question. 
In every poisoning case he is. closely questioned as to the largest dose of the 
drug in question that has been taken with impunity, and the smallest dose 
that has killed, and he is expected to have the cases of reported idiosyncrasies 
and tolerance at his immediate command. A widow with a child of ten 
months' gestation may be saved the loss of reputation by mention of the 
authentic cases in which pregnancy has exceeded nine months' duration ; the 
proof of the viability of a seven months' child may alter the disposition of 
an estate ; the proof of death by a blow on the epigastrium without external 
marks of violence may convict a murderer ; and so it is with many other 
cases of a medicolegal nature. 

It is noteworthy that in old-time medical literature — sadly and unjustly 
neglected in our rage for the new — should so often be found parallels of our 
most wonderful and peculiar modern cases. AVe wish, also, to enter a mild 
protest against the modern egotism tiiat would set aside with a sneer as 
myth and fancy the testimonies and reports of philosophers and physicians, 
only because they lived hundreds of years ago. We are keenly appreciative 
of the power exercised by the myth-making faculty in the past, but as ap- 
plied to early physicians, we suggest that the suspicion may easily be too 
active. When Pare, for example, pictures a monster, we may distrust his 
art, his artist, or his engraver, and make all due allowance for his primitive 
knowledge of teratology, coupled with the exaggerations and inventions of the 
wonder-lover; but when he describes in his own writing what he or his confreres 
have seen on the battle-field or in the dissecting room, we think, within moder- 
ate limits, we owe him credence. For the rest, we doubt not that the modern 
reporter is, to be mild, quite as much of a myth-maker as his elder brother, 
especially if we find modern instances that are essentially like the older cases 
reported in reputable journals or books, and by men presumably honest. In 


our collection we have ciuloavored, so far as possible, to cite similar cases 
from the older and from the more recent literature. 

This connection suggests the question of credibility in general. It need 
hardly be said that the lay-journalist and newspaper reporter have usually been 
ignored by us, simply because experience and investigation have many times 
proved that a scientific fact, by presentation in most lay -journals, becomes in 
some mysterious manner, /y;.so facto, a scientific caricature (or worse !), and if 
it is so with liicts, what nmst be the etfeet upon reports based upon no fact 
whatsoever? It is manifestly impossible for us to guarantee the credibility 
of chronicles given. If we have been reasonably certain of unreliability, 
we may not even have mentioned the marvelous statement. Obviously, we 
could do no more with apparently credible cases, reported by reputable medi- 
cal men, than to cite author and source and leave the matter there, where 
our responsibility nuist end. 

But where our proper responsibility seemed likely never to end was in 
carrying out the enormous labor requisite for a reasonable ceiininty that we 
had omitted no searching that might lead to undiscovered facts, ancient or 
modern. Choice in selection is always, of course, an aifair de gustibus, and 
especially when, like the present, there is considerable embarrassment of 
riches, cou[)led with the purpose of compressing our results in one handy 
volnuK'. In brief, it may be said that several years of exhaustive research 
have been spent by us in the great medical libraries of the United States and 
Europe in collecting the material herewith presented. If, despite of this, 
omissions and errors are to be found, we shall be grateful to have them 
pointed out. It must be remembered that limits of space have forbidden 
satisfactory discussion of the cases, and the prime object of the whole work 
has been to carefully collect and group the anomalies and curiosities, and 
allow the reader to form his own conclusions and make his own deductions. 

As the entire labor in the preparation of the forelying volume, from the 
inception of the idea to the completion of the index, has been exclusively the 
personal work of the authors, it is with full confidence of the authenticity of 
the reports quoted that the material is presented. 

Complete references are given to those facts that are comparatively un- 
known or unique, or that are worthy of particular interest or further investi- 
gation. To prevent unnecessary loading of the book with foot-notes, in those 
instances in which there are a number of cases of the same nature, and a descrip- 
tion has not been thought necessary, mere citation being sufficient, references 
are but briefly given or omitted altogether. For the same reason a biblio- 
graphic index has been added at the end of the text. This contains the 
mf)st imjiortant sources of information used, and each journal or book therein 
has its own numl)er, which is used in its stead all through the book (thus, 
476 signifies The Lancet, Tiondon ; 597, the Xew York Medical Journal; 
etc.). These bibliographic munbers begin at 100. 


Nohvithstandiug that every effort has been made to conveniently and satis- 
factorily group the thousands of cases contained in the book (a labor of no 
small proportions in itself), a complete general index is a practical necessity 
for the full success of what is essentially a reference-volume, and conse- 
quently one has been added, in which may be found not only the subjects under 
consideration and numerous cross-references, but also the names of the 
authors of the most important reports. A table of contents follows this 

AVe assume the responsibility for innovations in orthography, certain 
abbreviations, and the occasional substitution of figures for large numerals, 
fractions, and decimals, made necessary by limited space, and in some cases 
to more lucidly show tables and statistics. From the variety of the reports, 
uniformity of nomenclature and numeration is almost impossible. 

As we contemplate constantly increasing our data, we shall be glad to 
receive information of any unpublished anomalous or curious cases, either of 
the past or in the future. 

For many courtesies most generousl}'" extended in aiding our research- 
work we wish, among others, to acknowledge our especial gratitude and in- 
debtedness to the officers and assistants of the Surgeon-General's Library at 
Washington, D. C, the Library of the Royal College of Surgeons of Lon- 
don, the Library of the British Museum, the Library of the British jNIedical 
Association, the Bibliotheque de Faculte de Medecine de Paris, the Biblio- 
th^que Xationale, and the Library of the College of Physicians of Phila- 

George M. Gould. 

Philadelphia, Octoher, 1896. Walter L. Pyle. 





Menstruation, 17 — Vicarious and compensatory, 18 — From the skin, 18-— 
From the breasts, 19 — From the eyes, 23— From the ears, 24— From the mouth, 
24 — From the extremities, 2'i — From okl ulcers, wounds, or cicatrices, 25 — 
From the rectum or urinary tract, 26 — After removal of the uterus or ovaries, 
26— Hematemesis as a means of, 27 — Migratory, 27— Postmortem, 27 — Black, 
27 — Suppression of, 27 — In man, 27 — Vicarious, in the male, 28— During preg- 
nancy and lactation, 28 — Child-beariug after cessation of, 29 — Precocious, 29 
— Protracted, 32 — Late establishment of, 33 — Precocious impregnation, 34 — 
Twins born to a child mother, 38— Pregnancy before the appearance of menstru- 
ation, 38— Fecundity in the old, 38 — Multiple births in the aged, 40 — Impreg- 
nation without completion of the copulative act, 40 — Artificial impregnation, 42 
— Unconscious impregnation, 45 — Conception with deficient organs, 45 — Concep- 
tion soon after a preceding pregnancy, 46 — Superfetation, 46 — Children of differ- 
ent colors, 48. 



Extrauterine pregnancy, 50 — Termination of, 51 — Abortion by the mouth, 
52 — Discharge of fetal bones by the rectum, 52 — By the urinary passages, 53 — 
Discharge of the fetus through the abdominal walls, 53 — Combined intrauterine 
and extrauterine gestation, 54 — Triple ectopic gestation, 57 — Delivery of a viable 
extrauterine fetus, 57 — Ultimate fate of viable ectopic children, 62 — Long reten- 
tion of extrauterine pregnancy, 62 — Long retention of uterine pregnancy, 63 — 
Long continuation of fetal movements, 64 — Duration of pregnancy, 65 — Short 
pregnancies, 65 — The incubator, 68 — Prolonged pregnancies, 68 — Unconscious 
pregnancy, 72 — Pseudocyesis, 73 — Sympathetic male nausea of pregnancy, 79 — 
Perverted appetites of pregnant women, 80 — ]\Iaternal impressions, 81 — Paternal 
impressions, 85 — Telegony, 86 — Antenatal pathology, 89 — Transmission of con- 
tagious diseases to the fetus in utero, 90— Small-pox, 90 — Varicella, measles, 
pneumonia, and malaria, 91 — Effects on the fetus in utero of medicine adminis- 
tered to the pregnant mother, 92 — Intrauterine amputations, 94 — Intrauterine 
fractures, 97— Multiple fetal fractures, 97— Results to the fetus of injuries to the 
pregnant mother, 98 — Injuries about the genitalia, 98— Injuries from cattle-horns, 
99— ]\Iaj or accidents in pregnant women, 100 — Operations during pregnancy, 103 
— After-effects of abdominal hysteropaxy on subsequent pregnancies, 106— Coex- 
istence of an extensive tumor of the uterus with pregnancy, 106 — Protrusion of 
the membranes from the vulva several weeks before confinement, 107 — Anomalies 
of the umbilical cord, 109— Anomalous causes of abortion, 109 — Abortion of 
one twin, 110 — Worms in the pregnant uterus. 111. 






General considerations, 113 — Painless births, 113 — Birth during intoxication, 
114 — During hypnotism, 114 — During sleep, lethargies, trances, etc., 114 — Rapid 
parturition without usual symptoms, 116 — Unusual places of birth, 119 — Birth 
by the rectum, 120 — Through perineal perforation, 121 — Through the abdominal 
wall, 122 — Of the fetus enclosed in the membranes, 122 — Dry births, 123 — Post- 
mortem delivery, 123— Antepartum crying of the fetus, 127 — Cesarean section, 
128 — Repeated Cesarean section, 130 — Cesarean section by the patient herself, 
131 — Abdominal section and delivery by cattle-horns, 133 — Delivery by a can- 
nonball, 134 — Postmortem Ce.sarean section, 135 — Rupture of the irterus during 
pregnancy, 137 — Spontaneous rupture of the vagina, 138 — Sloughing of the geni- 
tals after parturition, 138 — Accidental extraction of the prolapsed pelvic organs, 
139— Accidents incident to labor, 140— Symphysiotomy, 141 — Delay in the birth 
of the second twin, 142. 



General historic observations, 144 — General law, and influence of war, 144 
— Influence of rural and urban life, 14.5 — Effect of climate and race, 145 — Ancient 
and modern prolificity, 146 — Legal encouragement, 146 — Old explanations of 
proiificity, 146 — Greatest number of children at a single birth, 147 — Proportion 
of multiple Dirths, 147 — Examples of multiple births, 148 — Twins and triplets, 
148 — Quadruplets, 148— Quintuplets. 150 — Sextuplets, 152 — Multiple births 
over six, 152 — Seven, 152 — Eight, 153 — Nine, 153 — Eleven, 153 — Twelve, 154 — 
Thirteen. 154 — Fifteen, 154 — Repetition of multiple births, 154 — Father of 87 
children by two wives, 156— Extreme prolificity by single births, 157 — Possibil- 
ities of paternity, 157 — Multimarriages, 159 — Possible number of descendants, 
159 — Animal prolificity, 160. 



Monstrosities, 161 — Ancient explanations, 161 — Early teratology, 164 — 
Double hermaphroditic terata, 165 — Scieutiiic teratology, 165 — Artificial produc- 
tion of mousters, 166 — Animal teratology, 166 — Classification of monsters, 167 — 
Triple monsters, 167 — Double monsters, 167 — Hindoo sisters, 168— Siamese 
twins, 168 — Radica-Doddica, 171 — Operations on conjoined twins, 172 — Cranio- 
pagi, 17.3 — Pygopagi, 174 — Biddenden maids, 174 — Helen and Judith, 177 — 
Millie-Christine, 179 — Rosa-Josepha Blazek, 179 — Tynberg's case, 180 — Ischi- 
opagi, li^l — Louis and Louise, 181 — Marie-Louise and Hortense-Honorine, 182 
— Minna and Minnie Finley, 183 — Jones twins, 183 — Scottish brothers, 184 — 
Ritta-Christina, 184 — Tocci brothers, 186— ]\Iarie-Rosa Drouin, 186 — Bicephalic 
monsters, 187 — Edward ^lordake, 188 — Fantastic monsters, 189 — Parasitic 

terata, 189 — Lazarus- Joannes Baptista Colluredo, 191 — Louise L , 192 — 

"Laloo," 192— "A-Ke," 193— Duplication of the lower body, 193— Blanche 

Dumas, 194 — Mrs. B , 194 — Diphallic terata, 194— Jean Baptista dos Santos, 

196— Fetus in fetu, 199 — Dermoid cysts, 202 — Multiple dermoids, 20.5 — Herma- 
phroditism, 206 — Interesting instances of, 206— Catherine or Charles Hoffman, 
207 — Marie Madeline Lefort, 207 — Spurious hermaphroditism, 211 — Law of 
evolution in hermaphroditism, 211 — Neuter hermaplirodites, 212 — Marie Doro- 
th6e, 212 — Legal aspect of hermaphroditism, 212. 





Ancient ideas relative to minor terata, 213 — Teratoscopy, 213 — Congenital 
defect of the epidermis, 217 — Elasticity of the skiu, 217 — " Elastic-Skin Man," 
217 — Dermatolysis, 217 — Abnormal development of the scalp, 218 — Impervious 
skin, 219 — Albinism, 220 — Partial albinism, 221 — Melanism, 222 — Human horns, 
222 — Anomalies of the hair, 226 — Congenital alopecia, 226— Sexualism and hair- 
growth, 228— Bearded women, 228 — Hypertrichosis, 230 — "Dog-face men," 231 
— Nsevus pilosus, 232 — Hair and beard of great length, 234 — Accidental growths 
of hair, 235 — Anomalies of the color of the hair, 235 — Sudden canities, 235 — 
Temporary and partial canities, 238 — Anomalous color-changes of the hair, 239 
— Chemic colorations of the hair, 240 — Curious causes of alopecia, 241 — Anoma- 
lies of the nails, 241 — Anomalies of dentition, 242 — Triple dentition, 243 — Eden- 
tulousness, 243 — Excessive dentition, 244— Supernumerary teeth, 244 — Extraoral 
dentition, 244 — Anomalies of the head, 245 — Life without a cerebrum, 246 — 
Defective development of the cerebellum, 246 — Microcephaly, 247 — Artificial 
microcephaly, 248 — ISlacrocephaly, 248 — Largest healthy brains on record, 249 — 
Hydrocephaly, 250 — Deficiency of the cranial bones, 250 — Anomalies of the 
maxillary l)ones, 251 — Congenital absence of the nose, 252 — Large and small 
noses, 252 — Congenital division of the nose, 252 — Macrostoma, 253 — Microstoma, 
252 — Congenital atresia of the mouth, 253 — Anomalies of the lips, 254^Hare-lip, 
254 — Congenital al)sence of the tongue, 254 — Bifid and supernumerary tongues, 
255 — Large and small tongues, 256 — Anomalies of the palate and uvula, 256 — 
Of the epiglottis, 256 — Double epiglottis and double voice, 257 — Anomalies of 
eyes, 257 — Absence of the eyes, 257 — Living cyclopia, 258 — "Four-eyed man of 
Cricklade," 258 -Anomalies of lids, 259— Of the iris, 259— Of the lens, 260— 
Heredity in the causation of congenital defects of the eye, 260 — Anomalies of the 
ears, 261 — Absence of the limbs, 263 — Supernumerary limbs, 269 — Anomalies of 
the feet, 270— Of the hand, 270 — Absence of the digits, 271— Supernumerary 
digits, 273 — Hypertrophy of the digits, 276— Talipes, 276 — Anomalies of the 
vertebrae, 277 — Human tails, 277 — Vestigial remains, 279 — Anomalies of the 
spinal canal and contents, 280— Supernumerary ribs, 281 — Fissure of the ster- 
num, 282 — Other thoracic defects, 284 — Branchial fissures, 284 — Anomalies of 
the esophagus, 284 — Anomalies of the lungs, 285 — Of the diaphragm, 285 — Of 
the stomach, 286— Of the intestines, 287— Dilatation of the colon, 287—" Bal- 
loon-man," 287 — Imperforate anus, 288 — Anomalies of the liver, 290 — Of the 
spleen, 290 — Transposition of the viscera, 291 — Congenital extroversion or even- 
tration, 292— Anomalies of kidney, 293— Of the ureters, 294— Of the bladder, 295 
— Exstrophy of the ])ladder, 295 — Anomalies of the heart and vascular sj^stem, 
296— Of the breast, 297— Amazia, 297— Micromazia. 298— Polymazia, 298— 
Anomalies of the hymen, 302 — Of the female external genitals, 303 — Absence of 
the vagina, 303 — Duplex vagina, 304 — Transverse septa of the vagina, 305 — 
Anomalous openings of the vagina, 305 — Anomalies of the labia, 306 — Absence 
of the nymphis, 306 — Enlarged nymphse, 306 — Hottentot women, 307 — Ceremo- 
nial enlargement of the nymphae, 307 — Anomalies of the clitoris, 307 — Circum- 
cision of the clitoris in Egypt, 308 — Absence of the ovaries, 309 — Prolapse of the 
ovaries, 310 — Supernumerary ovaries, 310 — Anomalies of the Fallopian tubes, 
311— Of the uterus, 311 — Absence of the uterus, 311 — Double uterus, 311 — Preg- 
nancy with double uterus, 311— Triple uterus, 313 — Hernia of the uterus, 313 — 
Absence of the penis, 314 — Rudimentary development of the penis, 315 — Penis 
palme, 316— Torsion of the penis, 316— Ossification of the penis, 316— Absence 
of the frenum and prepuce, 317 — Anomalies of the urethra, 317 — Duplication of 
the urethra, 317 — Hypospadias and epispadias, 318 — Artificial penis, 318 — An- 



orcnisni, 319 — Monorchism, 319 — Polyorchism, 3'20 — Cryptorchism, 321 — Anom- 
alous position of the testicles, 322 — Inversion of the testicle, 323 — Anomalies of 
the seminal vesicles, 323. 



Giants, 324 — Ancient giants, 324 — Discoveries of giants' bones, 325 — Gen- 
eral opinions, 326 — Association of acromegaly with gigantism, 327 — Celebrated 
giants, 328— Giants of history, 333— Dwarfs, 333— Pygmies, 333— Artificial pro- 
duction of dwarfs, 335 — Ancient popularity of dwarfs, 336 — Intellectual dwarfs, 
337 — Women predisjwsed to give birth to dwarfs, 337 — Species of dwarfs, 338 — 
Celebrated dwarfs, 338— Geoffrey Hudson, 338— Gilison, 338— B6bc, 339— Borwi- 
laski, 339— Greatage in dwarfs, 339— Robert Skinner, 340—" Tom Thumb," 342 
— Lucia Zarete, 343 — Precocious development, 343 — "Man-lwys," 343 — Small 
new-born infants. 347 — Large new-born infants, 348 — Congenital asymmetry 
and hemihypertrophy, 350 — Obesity, 352 — Fat chiklreri, 352 — General remarks 
on obesitj', 354 — Treatment of obesity, 356 — Remarkable instances of obesity, 
356 — Simulation of obesity, 360 — "Adiposis dolorosa,'' 360 — Abnormal leanness, 
363 — "Living skeletons," 364 — Extreme muscular atrophy, 364. 


LONGEVITY 365-382 

Scope of the article, 365 — General opinions, 365 — Testimony of statistics, 365 
— Natural term of life, 366 — Censuses of centenarians, 366 — Effect of class-influ- 
ences, occupation, etc., 367 — Longevity in ancient times, 368 — Difference in 
chronology, 308 — Alchemy and the "elixir of life," 368 — Longevity in Jewish 
history, 369 — In Egypt, 370 — Among the ancient Chinese, 370 — Among the 
Greeks, 370 — Among the Romans, 370 — Among hermits and ecclesiastics, 370 — 
Among the Brahmin priests of India, 371 — Influence of mental culture, 371 — 
Compatibility of mental and physical activity with longevity, 371 — Longevity 
among the Royalty, 372 — Influence of personal habits, 372 — Remarkable in- 
stances of longevity, 373 — Henry Jenkins, 373 — Thomas Parr, 373 — Jean Korin, 
373 — Setrasch Czarten, 373 — Sundry instances of great age, 374 — Generative 
ability in old age, 376 — Influence of stimulants, 377 — Rejuvenescence of the 
senses inpge, 378 — Heredity in longevity, 379 — Longevity among physicians, 381 
— Recent instances of longevity, 382. 



Anomalies of the secretions, 383 — Colored saliva, 383 — Abnormalities of uri- 
nation, 383 — Metastasis of tears, 384 — Anomalies of the semen, 384 — Blue bile, 
385 — Chroraidrosis, 385 — Hyperidrosis, 386 — Unilateral and localized sweating, 
387 — Blood}' sweat or "stigmata," 388 — Louise Lateau, 389 — Postmortem 
sweating, 391 — Anomalies of lactation, 391 — Milk-metastasis, 391 — Lactation in 
the new-born, 392 — In children, 392 — In the aged, 393— Prolonged lactation and 
galactorrhea, 394 — Gynecomazia, 394— Men suckling infants, 397 — Human odors, 
397 — Individual odors. 398 — Modifying causes, 398 — Odors of races, 399— Odor 
of the breath after coitus, 399 — Influence of the emotions, 399 — Odors associated 
■with mental and nervous diseases, 401 — The odor of insanity, 400 — Odors of some 
diseases, 401 — Odor of the hair, 401 — Sexual influence of odors, 401 — Fetichism, 
401 — Sexual influence of the olfactorj' sense in animals, 402 — Bulimia, 403 — 



Polydipsia, 404 — Polydipsia among glass-blowers, 405 — Hydroadipsia, 405 — 
Perverted appetites, 405 — Anthropophagy, 406 — Cannibals, 407 — Ancient cus- 
toms, 409 — Depraved appetite for human flesh in civilization, 409 — Further ex- 
amples of depraved appetites, 411 — Pica, 412 — Chalk-eating, 412 — Arsenic eating, 
413 — Fasting, 413 — Older instances, 414 — "Fasting girls," 418 — Modern in- 
stances of fiisting, 419 — Fasting exhibitionists, 420 — Anomalies of temperature, 
421--Hyperthermy reaching 148° F., 423^Endurauce of external heat, 424 — 
"Human Salamanders," 424 — Fire-worshii), 425 — Spontaneous combustion of 
the human body, 42G — Magnetic, phosphorescent, and electric anomalies, 429 — 
Effects of cold, 431 — Effects of working in compressed air, 433 — Remarkable 
development of the remaining senses when one or more are lost, 432 — Examples 
of compensatory sense-development, 433 — Laura Dewey Bridgman, 43 — Helen 
Kellar, 435— Edith Thomas, 437— Eemarkable blind savants, 439— Feats of 
memory, 439 — Boy calculators, etc., 439 — Jacques Inaudi, 439 — Oscar Moore, 439 
— Wolf-children, 444 — Artificial manufacture of " wild boys," 448 — Equilibrists, 
449 — Rope-walkers, 449 — Blondin, 450 — Human pyramids, 450 — Jugglers, 451 
— Marksmen, 452 — Ventriloquists, 453 — Athletic feats, 455 — Public contests of 
Greece, 455 — Runners, 455 — Couriers, 456 — Indian runners, 457 — Jinrickisha- 
men, 457 — Letter-carriers of India, 458 — "Go-as-you-please" pedestrians, 458 
— Modern records for running, 459 — Long-distance traversing, 459 — Riders, 460 
— Influence of the spleen in running, 461 — Swimming, 461 — Jumpers and acro- 
batic tumblers, 462 — Extraordinary physical development and strength, 463 — 
Modern Hercules, 464 — Strong women, 468 — Strength of the jaws, 468 — Strength 
in the hands, 470 — Fraudulent "strong men," 470 — OfiScially recorded feats of 
strength, 470 — Contortionists, 473 — Dislocationists, 473 — Endurance of pain, 475 
— Ai'ssaoui, 476 — Malingerers, 478 — Hypersensitiveness to pain, 480 — Relation 
of pain to shock, 480 — Morbid desire lor pain, 480 — Pain as a means of sexual 
enjoyment, 480 — Masochism, 480 — Flagellation, 480 — Fatal flogging, 481 — Idio- 
syncrasies, 481 — Idiosyncrasies in relation to the sense of smell, 482 — Of the 
sense of hearing, 484 — To music, 485 — Theraiieutic value of music, 485 — Idiosyn- 
crasies as to vision, 487 — Of the sense of touch, 488 — Idiosyncrasies to foods, 489 
—Eggs, 490— Parsley, 491— Rice, 491— Figs, 491— Wheat-flour, 492 -Food su- 
perstitions, 493 — "Totemism," 494 — Idiosyncrasies to drugs, 496 — Acids, 497 — 
Antimony, 499— Arsenic, 500— Belladonna, 500— Digitalis, 502— Ergot, 502— 
Epsom salts, 503 — lodin, 503 — Iodoform, 503 — Lead-poisoning, 503 — Mercury, 
504 — Croton oil, 504 — Castor oil, 504 — Opium and its derivatives, 505 — Chronic 
opium-eating, 506 — Phosphorous, 508 — Pilocarpin, 508 — Quinin, 509 — Strych- 
nin, 510 — Idiosyncrasies in coitus, 511 — Death in coitus, 513 — Suspended anima- 
tion, 513 — Prolonged submersion, 513 — Divers, 514 — Suspension of the cardiac 
movements at will, 516 — Hibernation, 517 — Human hibernation, 517 — Fakirs of 
India, 517 — Recovery after asphyxia from hanging and strangling, 519 — Prema- 
ture burial, 519 — Postmortem anomalies, 522 — Movements of a corpse, 522 — 
Postmortem priapism, 523 — Retardation of putrefaction, 523 — Postmortem 
growth of hair and nails, 523 — Untoward effects of the emotions on the vital 
functions, 523 — Death from joy and laughter, 524 — Death from grief and sorrow, 
524 — Death from fear, 525 — Death from shock alone following blows that cause 
no visible injury, 525 — Death from the "wind of the cannon-ball," 526. 



Injuries to the eye, 527 — Exophthalmos, 527 — Avulsion of the eye, 527 — 
Rupture of the eyeball, 528— Serious sequels of orbital injuries, 528 — Gunshot 
injuries of the orbit, 529 — Foreign bodies in the orbit, 531 — Foreign bodies in 
the eyeball, 532 — Dislocation of the lens, 533 — Injury to the eyeball by birds. 



533 — Rare accident to the eye, 533 — Epistaxis through the eyes, 534 — Late res- 
toration of sijiht, 535 — Sight sjioutaneously restored, 536 — Nyctalopia, 536 — 
Ileineralopia, 536 — Sno\v-l)lindness, 537 — Ketinal injury from cxixisure to intense 
liglit, 537 — Electric-light injuries of the eye, 537 — Injuries to the ear, 537 — 
Boxing the ears, 537 — Ivnpture of the tympanum, 537 — Perforation of the tym- 
panum, 538 — Objective tinnitus aurium, 538— Insects in the ear, 53J) — Otiier 
foreign bodies in the ear, 53!) — .Seal])-injuries, 54"2 — Cerebral injuries, 545 — Pene- 
tration and transfixion of the brain, 545 — Gunshot injuries of the Ijrain, 549 — 
Study of gunshot injuries of the brain, 551 — Head-injuries with loss of cerebral 
substance, 551 — "American Crow-bar Case," 551 — Loss of brain-substance from 
cerebral tumor, 557 — Extensive fractures of the cranium, 558 — Diving into 
shallow water, 559 — Fracture of the internal table of the cranium, 559 — Fracture 
of the cranial base, 559 — Foreign l)odies in the brain, 559 — Injuries of the nose, 
561 — Nose-making, 561 — Deformities of the nose, 563 — Insects in the nose, 563 
— Foreign l)odies in the nose, 564 — Tongue-swallowing, 565 — Tongue-sucking, 
565 — Injuries to the tongue, 565 — Regeneration of a severed tongue, 565 — Artic- 
ulation without a tongue. 5(56 — Hypertrophy of the tongue, 566 — Macroglossia, 
567 — Living fish in the pharynx, 567 — Leech in the pharynx, 569 — Foreign 
bodies in the pharynx and esophagus, 570 — Migration of foreign bodies from the 
esophagus, 571 — Abscess or ulceration into neighboring blood-vessels, consequent 
upon lodgment of foreign bodies in the esophagus, 571 — Esophagotomy, 574 — 
Injuries of the neck, 574 — Ligature of the common carotid artery, 575 — Nonfatal 
perforating wounds of the trachea and esophagus, 575 — Self-decapitation, 576 — 
Cases of nonfatal cut-throat, 577 — Injuries of the cervical vertebra?, 578 — Foreign 
bodies in the larynx and trachea, 580 — Impaction of artificial teeth in the larynx, 
582 — ExcisiDU of the lar3mx. 584 — Injuries destroying great portions of the face 
or jaw, ,but not causing death, 585 — A curious accident, 587. 



Reunion of severed digits, 588 — Reproduction and accidental production of 
nails, 588 — Avulsion of a finger with the entire tendon, 589 — Avulsion of the 
arm, 590 — Avulsion of the leg, 592 — Injuries to the sciatic nerve, 592 — Recovery 
of an injured member after extensive severance and loss of siibstauce, 593 — Rup- 
ture of the quadriceps tendon, 594— Spontaneous fractures, 594 — Evolution of 
the treatment of dislocations, 594 — Anomalous dislocations, 594 — Congenital 
dislocations, 595 — Major amputations, 596 — ^lultiple amputations, 596 — Sponta- 
neous amputation, 597 — Artificial limbs, 598 — Dismembered athletes, 598 — 
Foreign bodies in 'the extremities, 599 — Osteomalacia, 600 — Rachitis, 601 — 
Achondrojjla.sia, 602 — Osteitis deformans, 603 — Deformities of the articulations, 
603 — "Camel-boy," 603 — Deformities from infantile spinal paralysis, 604 — 
Anomalous growth of bones of the extremities, 605. 



Injuries of the lung and bronchus, 606 — Loss of lung-tissue, 607 — Surgery 
of the lung, 608 — Excision of diseased portions of the lung, 608 — Rupture of the 
lung without fracture of the rib, 608— Siwntaneous rupture of the lung, 609 — 
Penetration and transfixion of the thoracic cavity, 610 — Recovery after major 
thoracic wounds, 611 — Wounds of the diaphragm, 612 — Diaphragmatic hernia, 
612 — Peritonitis in the thoracic cavity, 613 — Foreign bodies in the thoracic 
cavity, 613 — Foreign bodies in the bronchi, 614 — Cardiac injuries, 616 — Instances 



of survival after cardiac iujuries, 617 — Nonfatal cardiac injuries, 620 — Foreign 
bodies in the heart, 624 — Injuries to the pericardium, 624 — Euptureof the heart, 
625 — Disphicement of the heart, 626 — Hypertrophy of the heart, 626 — Wounds 
of the aorta, 626 — Suudrj' cases of vascular injuries, 627 — Rupture of the esoph- 
agus, 628 — Rupture of the stomach, 629 — Voluntary vomiting, 630 — Wounds of 
the stomach, 630 — Alexis St. Martin, 630 — Gastric fistulse, 631 — Gastrotomy 
performed on knife-swallowers, 633 — Sword-svvallowiug, 633 — Swallowing 
knives, pebbles, glass, etc., 635 — Living animals in the alimentary canal, 636 — 
Other foreign bodies in the alimentary canal, 637 — Hair-swallowing, 641 — 
Foreign bodies in the intestines, 641 — Foreign bodies in the vermiform appendix, 
642 — Intestinal injuries, 642 — Successful intestinal resection, 643 — Sloughing of 
the intestines following intussusception, 643 — Rupture of the intestines, 644 — 
Operations upon the gastro-intestinal tract, 644 — Gastrostomy, 644 — Pyloro- 
plasty, 644 — Pylorectomy, 644 — Gastrectoiuy, 644 — Enterostomy, 645 — Colos- 
tomy, 645 — Intestinal anastomosis, 645 — Foreign bodies in the rectum, 645 — 
Transfixion of the abdomen, 648 — Evisceration, 650 — Nonfatal perforating gun- 
shot wounds of the abdomen, 651 — Bullets voided from the bowel and bladder, 
651 — Wounds of the liver, 652 — Surgery of the liver, 652 — Resection of the liver, 
654 — Floating liver, 655 — Hypertrophy of the liver, 655 — Ruptui'e of the gall- 
bladder, 65.5 — Cholecj'stotomy and cholecystectomy, 655^Rupture of the spleen, 
656 — AVounds of the spleen. 656 — Splenectomy, 656 — Hypertrophy of the spleen, 
657 — lujirries of the thoracic duct, 657 — Ligation of the abdominal aorta, 658 — 
Ligation of the common iliac artery, 658 — Foreign bodies loose in the abdominal 
cavity, 658 — Foreign bodies in the skin and muscles of the back, 659 — Fracture 
of the lower spine, 659 — Laminectomy, 660 — Injuries to the spinal cord, 661 — 
Hernia, 662 — Spontaneous rupture of the abdominal walls, 666. 



Wounds of the kidney, 667 — Operations on the kidney, 668 — Rupture of the 
ureter, 668 — Operations on the ureter, 669 — Stricture of the ureter, 669 — Rupture 
of the bladder, 670 — Gunshot wounds of the bladder, 671 — Penetration of the 
bladder through the anus, vagina, or buttocks, 671 — Arrow-wound of the bladder 
through the buttocks, 672 — Wounds of the bladder followed by calculi, 673 — 
Fistulre of the Ijladder, 675 — Worms in the bladder, 676 — Foreign bodies in the 
bladder, 676 — Hair in the bladder, 678 — Foreign bodies in the pelvis, 678 — Rup- 
ture of the urethra, 679 — Fracture of the penis, 679 — Urethral stricture, 680 — 
Sundry injuries to the penis, 680 — Amputation of the penis, 680 — Gunshot 
wounds of the penis, 681 — Luxation of the penis, 681 — Spontaneous retraction 
of the penis, 681 — Spontaneous gangrene of the penis, 682 — Prolonged priapism, 
683 — Theories of priapism, 684 — Injuries of the testicles and scrotum, 685 — 
Avulsion of the male external genitalia, 686 — Preservation of sexual power after 
injuries of the genitals, 687— Atrophy of the testicles, 687 — Retraction of the 
testicles, 688 — Ectopia of the testicles, 688 — Rupture of the spermatic vessels, 689 
— Hj'drocele, 689 — Separation of an ovary, 689 — Injuries of the vagina, 689 — 
Rupture of the clitoris, 691 — Discharge of the vaginal parietes, 691 — Injuries 
during coitus, 691 — Foreign bodies iu the vagina, 692 — Long retention of pessa- 
ries, etc., 693 — Leech in the vagina, 694 — Foreign bodies in the uterus, 695. 



Marvelous recoveries from multiple iujuries, 697 — Recoveries after injuries 
by machinery, with multiple fractures, etc., 699 — Miscellaneous multiple frac- 


tures, 701 — Recoveries from high falls, 703 — High dives, 704 — Resistance of 
children to injuries, 705 — Instances of infant-vitality, 70(5 — Operations on the 
extreme young and old, 706 — Repeated operations, 707 — Billroth's marvelous 
operation, 708 — Self-performed surgical operations, 708 — Instances of extensive 
loss of blood, with recovery, 709 — Extensive venesection, 700 — Spontaneous 
hemorrhages, 709 — Arrow-wounds, 710 — Arrow-poison, 711 — ^Multiitlc arrow- 
wounds, 711 — Serious insect-stings, 713 — Syphilis from a llea-bite, 714 — Snake- 
bites, 715 — Hy(lrophol)ia, 719 — Shark-bites, 721 — Leprosy from a fish-bite, 721 — 
Alligator-bites, 722 — Animal-bites, 722 — Injuries from lightning-stroke, 722 — 
Recovery from lightning-stroke, 723 — Therapeutic effect of lightning-stroke, 726 — 
Grafting, 728 — Tooth-replantsirion, 728 — Muscle-transplantation, 729 — Tendon- 
transplantation, 729 — Nerve-grafting, 729 — Bone-grafting, 729 — Skin-grafting,729 
— Self-mutilations, 731 — Self-castration, 732 — Miscellaneous mutilations, 735 — 
"Needle-girls," etc., 73;') — Wanderingsof pinsand needles in the body, 736 — Prick 
of a pin causing death, 737 — Manufacture of crippled beggars, 737 — Chinese foot- 
binding, 737 — Professional leg-breaker, 741 — Anomalous suicides, 742 — Religious 
and ceremouial mutilations, 743 — Self-bleeding, 745 — ICxhibition of scars, 745 — 
Cosmetic mutilations, 746 — Manufacture of dimples, 74(> — AmputatioTi of the 
fingers, 746 — Knocking out the front teeth, 747 — Depilatory customs, 747 — Bor- 
ing the ear, 749 — Tattooing, 749 — Infection from tattooing, 751 — Infibulation, 
752— Chastity-girdles, 753 — Infibulation to prevent masturbation, 754 — Slitting 
the urethra, 754— Mutilations of the genital organs to prevent conception, 754 — 
Circumcision, 754 — Ceremonial ovariotomy, 755 — Castration, 755— Eunuch- 
makers, 756 — Castration because of excessive cupidity, 756 — Castration as a re- 
ligious rite, 756— The Skoptzies, 757. 



Tumors, 759 — Adenoma of the breast, 759 — Diftuse hypertrophy of the 
ttreast, 759 — Goiter, 761 — Extirpation of the thyroid gland, 762 — Fibromata, 
762— Multiple fibromata of the skin, 762 — Keloids, 764 — Lipomata, 764— Chon- 
dromata, 766 — Benign bone-tumors, 768 — Exostoses, 768— Gros-nez, 769 — Neu- 
romata, 770 — Carcinomata, 772 — Sarcomata, 772— Osteosarcoma, 772 — Varicose 
veins, 778 — Aneurysmal varix, 778 — Aneurysm, 779 — Large uterine tumors, 
780 — Ovarian cysts, 782 — Enormous dropsies, 786— Ankylosis of the articula- 
tions. 787 — "Ossified man," 787 — Petrefaction. 788 — Calculi, 788 — Large vesical 
calculi, 788 — Vesical calculi in ver}- young children, 790 — Multiple vesical cal- 
culi, 790 — Renal calculi, 790— Other extravesical calculi, 791 — Retention and 
suppression of urine, 792 — Persistent constipation, 794 — Elephantiasis arabum. 
795 — Elephantiasis of the lower extremities, 795 — Elephantiasis of the upper 
extremities, 798 —Elephantiasis of the face and scalp, 798 — Elephantiasis of the 
breast, 800 — Elephantiasis of the scrotum, 800 — Statistics of operations on ele- 
phantoid scroti, 803 — Acromegaly, 803 — Chiromegaly, 805— Megalocephaly, 805 
— Cretinism, 805 — Sporadic cretinism, 806 — Myxedema, 807 — Cagots, 808 — Per- 
sistent hiccough, 811 —Anomalous sneezing, 813 — " Ear sneezing," 815-Hemo- 
philia, 815 — Hemophilic purpura of the retina, 816 — Hemorrhagic diseases of the 
new-born, 816 — Syphilis ha^morrhagica neonatorum, 816— "NVinckcl's disease, 
816 — Barlow's disease, 817 — Tetanus neonatorum, 817 — Iluman parasites, 818 — 
Tapeworms, 818 — Ascarides, 819 — Trichinosis, 820 — Ecchinococcus, 820 — Fila- 
ria sanguinis hominis, 820 — "Eaten of worms," 821 — Bot-flj', 821 — Peenash, 





Icthyosis, 823—'' Porcupine-mau, " 823— " Biped Armadillo," 823— "Alli- 
gator-boy," 824 — Harlequin fetus, 825 — Contagious follicular keratosis, 825 — 
Keratodermia, 825 — "Hide-bound disease," 826 — Morphea, 826 — Scleroderma 
neonatorum, 826 — " Elephant-man," 827 — Aiuhum, 828 — Sclerodactylia annu- 
laris ainhumoides, 832 — Skin-shedding, 832 — "Snake-boy," 835 — Dermatitis 
exfoliativa neonatorum, 835 — Epidemic exfoliative dermatitis, 835 — Sphacelo- 
derma, 836 — Raynaud's disease, 836 — Spontaneous gangrene of the skin. 837 — 
Neuroses of the skin, 837 — -Neuroma cutis dolorosnm, 839 — Yaws, 839 — Furun- 
culosis orientalis, 840 — Pigmentary anomalies, 841 — Chloasma uterinum, 841 — 
Acanthosis nigricans, 841 — Xeroderma pigmentosum, 842 — Nigrities, 842 — 
Anomalous discolorations of the skin, 843 — Metallic discolorations of the skin, 
845 — Melasma, 845 — Leukoderma, 845 — "Leopard-boy," 845 — Canities un- 
guium, 847 — Plica polonica, 848 — Tinea nodosa, 849 — "Hair-eaters," 849 — My- 
cosis fungoides, 850 — Universal dermatitis, 851. 



Anomalous types of epilepsy, 853— The dancing mania, 853 — " Tarantism," 
854 — Palmus, 855 — Athetosis, 857 — Paramyclouus multiplex, 859 — Saltatoric 
spasm, 859 — Progressive muscular atrophy, 859 — Facial hemiatrophj-, 859 — Lin- 
gual hemiatrophy, 860 — Astasia-abasia, 860 — M^nifere's disease, 861 — Mery- 
cism, 862— Wakefulness, 863 — Somnambulism, 863 — Pathognomonic dreams, 
867 — Catalepsy, trance, and lethargy, 867— Hypnotism, 870 — African sleepsick- 
ness, 872— Aphasia, 872 — Aphasia after snake-bites, 874 — Anosmia, 874 — Hyper- 
osmia, 875 — Parosmia, 875 — Perversion of the tactile sense, 875 — Nostalgia, 876 
— Hypochondria, 876 — Fear-psychoses, 877 — Aichmophobia, 877 — Agoraphobia, 
877 — Aci'ophobia, 877 — Thalassophobia, 877 — Claustrophobia, 878 — Astrophobia, 
878 — Mysophobia, 878 — Hematophobia, 878 — Anthropophol)ia and monophobia, 
879 — Bacillophobia, 879 — Kleptomania and kleptophobia, 879— Folic de doute, 
879— Other rare fear-psychoses, 880 — Demonomania, 880 — Particular aversions, 
880 — Circular insanity, 881 — Katatonia, 882 — A modern Pygmalion, 882 — Double 
consciousness, 883 — Morbid sympathy of twins as illustrated in the " Corsican 
brothers, 887 — Automatism, 887 — Presentiment of approaching death, 889. 


Preliminary remarks on the great plagues, 891 — The black death, 892 — 
Mortality of, 893— Moral effect of, 894— The great plague of London, 895— 
Modern bubonic plagiie in China, 896 — Sweating sickness, 896 — Mortality of, 897 
— Chronologic table of the principal plagues, 898 — Small-pox, 903 — Inoculation, 
905 — Lady Montagu, 905 — Vaccination, 906 — Edward Jenner, 906 — Asiatic 
cholera, 908— Typhus fever, 910— Yellow fever, 910— Leprosy, 911— Syphilis, 
912 — Tuberculosis, 913 — Modern mortality from infectious diseases, 913. 


INDEX 931-968 




Menstruation has always been of interest, not only to the student of 
medicine, but to the lay-observer as well. In olden times there were many 
opinions concerning its causation, all of which, until the era of physiologic 
investigation, were of superstitious derivation. Believing menstruation to 
be the natural means of exit of the feminine bodily impurities, the ancients 
always thought a menstruating woman was to be shunned ; her very presence 
was deleterious to the whole animal economy, as, for instance, among the 
older writers we find that Pliny ^ remarks : " On the approach of a woman 
in this state, must will become sour, seeds which are touched by her become 
sterile, grass withers away, garden plants are parched up, and the fruit 
will fall from the tree beneath which she sits." He also says that the 
menstruating women in Cappadocia were perambulated about the fields to 
preserve the vegetation from worms and caterpillars. According to Flem- 
ming,^ menstrual blood was believed to be so powerful that the mere touch 
of a menstruating woman would render vines and all kinds of fruit-trees 
sterile. Among the indigenous Australians, menstrual superstition was so 
intense that one of the native blacks, who discovered his wife lying on his 
blanket during her menstrual period, killed her, and died of terror himself 
in a fortnight. Hence, Australian Avomen during this season are forbidden 
to touch anything that men use.*^ Aristotle said that the very look of a men- 
struating woman would take the polish out of a mirror, and the next person 
looking in it would be bewitched. Frommann*^ mentions a man who said 
he saw a tree in Goa which withered because a catamenial napkin was hung 
on it. Bourke remarks that the dread felt by the American Indians in this 
respect corresponds with the particulars recited by Pliny. Squaws at the 
time of menstrual purgation are obliged to seclude themselves, and in most 
instances to occupy isolated lodges, and in all tribes are forbidden to 

a 636, L. xxviii., cap. 23. ^ de Remediis, 16 aud 17. 

c Frazer, " The Golden Bough." d " Tractatus de Fasciuatione," Nuremberg, 1675. 
2 17 


prepare food for anyone save tlieniselves. It was believed that, -were a men- 
struatinir woman to step astride a rifle, a bow, or a laiu-e, the weapon would 
liavi' no litility. Medicine nu'ii arc in the hal)it of making a " protective" 
clause wlicncver thev concoct a " medicine," w liich is to the effect that the 
*' medicine " will be effective provided that no woman in this condition is 
allowed to approach the tent of the otticial in charge. 

Empiricism had doubtless tiuight the ancient husbamls the dangers of 
sexual intercourse during thi- period, and the after-results of many such con- 
nections were looked u})on as manifestations of the contagiousness of the evil 
excretions issuing at this period. Hence at one time menstruation was held 
in much awe and abliorrcnce. 

On the other hand, in some of the eastern countries menstruation was 
regarded as sacred, and the first menstrual disc^uirge was considered so valua- 
ble that premenstrual marriages were inaugurated in order that the first 
ovum might not be wasted, but fertilized, because it was supposed to be the 
purest and best for the purpose. Such customs are extant at the present day 
in some parts of India, despite the efforts of the British (government to sup- 
press them, and descriptions of child-marriages and their evil results have 
often been given by missionaries. 

As the advances of physiology enlightened the mind as to the true nature 
of the menstrual period, and the age of superstition gradually disappeared, 
the intense interest in menstruation vanished, and now, rather than being 
held in fear and awe, the physicians of to-day constantly see the results of 
copulation during this period. The uncontrollable desire of the husband and 
the mercenary' aims of the prostitute furnish examples of modern disregard. 

The anomalies of menstruation must naturally have attracted much 
attention, and we tind medical literature of all times rc])lete with examples. 
While some are simply examples of vicarious or compensatory menstrua- 
tion, and were so explained even by the older writers, there are many that are 
^y physiologic curiosities of considerable interest. Lh^ritier '*^'' furnishes the 
oft-(pU)ted history of the case of a young girl who suffered from suppression 
of menses, which, instead of flowing through the natural channels, issued 
periodically from vesicles on the leg for a period of six months, when 
the seat of the discharge changed to an eruption on the left arm, and con- 
tinued in this location for one year ; then the discharge shifted to a sore on 
the thumb, and at the end of another six months again changed, the next 
location being on the upper eyelid ; here it continued for a ])eriod of two 
years. Brierre de Boismont and Meisner descrilje a case apjxirently identical 
with the foregoing, though not (juoting the source. 

Haller, *"" in a collection of physiologic curiosities covering a ])eriod of a 
century and a half, cites 18 instances of menstruation from the skin. 
Parrot has also mentioned several cases of this nature. Chambers * speaks 

a 476, 1861, i.. '207. 


of bloody sweat occurring periodically in a woman of twenty-seven ; the 
intervals, however, were occasionally but a week or a fortnight, and the exu- 
dation was not confined to any one locality. Van Swieten^'^ quotes the 
history of a case of suppression of the menstrual function in which there 
were convulsive contractions of the body, followed by paralysis of the 
right arm. Later on, the patient received a blow on the left eye causing 
amaurosis ; swelling of this organ followed, and one month later blood 
issued from it, and subsequently blood oozed from the skin of the nose, and 
ran in jets from the skin of the fingers and from the nails. 

D'Andrade ^ cites an account of a healthy Parsee lady, eighteen years 
of age, who menstruated regularly from thirteen to fifteen and a half years ; 
the catamenia then became irregular and she suffered occasional hemorrhages 
from the gums and nose, together with attacks of hematemesis. The men- 
struation returned, but she never became pregnant, and, later, blood issued 
from the healthy skin of the left breast and right forearm, recurring every 
month or two, and finally additional dermal hemorrlingc developed on the fore- 
head. Microscopic examination of the exuded blood showed usual constituents 
present. There are two somewhat similar cases spoken of in French literature.'' 
The first was that of a young lady, who, after ten years' suppression of the 
menstrual discharge, exhibited the flow from a vesicular eruption on the 
finger. The other case was quite peculiar, the woman being a prostitute, 
who menstruated from time to time through spots, the size of a five-franc 
piece, developing on the breasts, buttocks, back, axilla, and epigastrium. 
Barham ^ records a case similar to the foregoing, in which the menstru- 
ation assumed the character of periodic purpura. Duchesne '^ mentions an 
instance of complete amenorrhea, in which the ordinary flow was replaced 
by periodic sweats. 

|/ Parrot speaks of a woman who, when seven months old, suffered from 
strumous ulcers, which left cicatrices on the right liand, from whence, at the 
age of six years, issued a sanguineous discharge with associate convulsions. 
One day, while in violent grief, she shed bloody tears. She menstruated at 
the age of eleven, and was temporarily improved in her condition ; but after 
any strong emotion the hemorrhages returned. The subsidence of the bleed- 
ing followed her first pregnancy, but subsequently on one occasion, when the 
menses were a few days in arrears, she exhibited a blood-like exudation from 
the forehead, eyelids, and scalp. As in the case under D'Andrade's obser- 
vation, the exudation was found by microscopic examination to consist of 
the true constituents of blood. An additional element of complication in 
this case was the occurrence of occasional attacks of hematemesis. 

Menstruation from the Breasts. — Being in close sympathy with the 
generative function, we would naturally expect to find the female mammae 

a 772, 1862. t> 162, 1829, 212, 236. 

c 656, 1847. d Monit. d' hop., 1856, iv., 661. 


involved in cases of anomalous menstruation, and the truth of this supposi- 
tion is substantiated in the abundance of such cases on record. Schenck ^ 
reports instances of menstruation from the nipple ; and Richter, de Fonte- 
cliia, Laurentius,'' Marcellus Donatus,*^ Amatus Lusitanus/^ and Bierling 
are st»me of the older writers who have observed this anomaly. Pare ^ says 
the wife of Pierre de Feure, an iron merchant, living at Chasteaudun, 
menstruated su»'h (piantities from the breasts each month that several ser- 
viettes were necessary to receive the discharge. Cazenave' details the his- 
toiy of a case in which the mammary menstruation was associated with a 
similar exudation from the face, and ^^'ollf *-' saw an example associated with 
hemorrhage from thi' fauces. In tlie Lancet (1840-1841) is an instance of 
monthly discharge from beneath the left mamma. Finley^ also writes of an 
example of manunary hemorrhage simulating menstruation. Barnes saw a 
case in St. George's Hospital, London, 1876, in which the young girl men- 
struated vicariously from the nipple and stomach. In a London discussion 
there was mentioned ' the case of a healthy woman of fifty who never was 
pregnant, and whose menstruation had ceased trvvo years previously, but who 
for twelve months had menstruated regularly from the nipples, the hemor- 
rhage being so profuse as to require constant change of napkins. The 
mammae were large and painful, and the accompanying symptoms were those 
of ordinatry menstruation. Boulger-^ mentions an instance of periodic men- 
strual discharge from beneath the left mamma. Jacobson ^ speaks of habitual 
menstruation by both breasts. Rouxeau' describes amenorrhea in a girl of 
seventeen, who menstruated from the breast ; and Teufard ^ reports a case 
in which there was reestablishment of menstruation by the mammae at the age 
of fifty-six. Baker" details in full the description of a case of vicarious men- 

^ struation from an ulcer on the right mamma of a woman of twenty (PI. 1). 

/ At the time he was called to see her she was suffering with what was called 
" green-sickness." The girl had never menstruated regularly or freely. 
The right mamma was quite well developed, flaccid, the nipple prominent, 
and the superficial veins larger and more tortuous than usual. The patient 
stated that the right mamma liad always been larger than the left. The 
areola was large and well marked, and ^ inch from its outer edge, imme- 
diately under the nipple, there was an ulcer with slightly elevated edges 
measuring about 1^ inches across the base, and having an opening in its center 
\ inch in diameter, covered with a thin scab. By removing the scab and 
making pressure at the base of the ulcer, drops of thick, mucopurulent 

a 718, L. ii., obs. 228 ; L. iv., obs. 266. ^ 480, L. v'ii., 278. 

c 306, L. iv., c. 26. d 119, cent, ii., cur. 21. 

e 618, 983. f 462, T. x., 23. 

g Obs. med.-chir., L. i., u. 20. ^ 256, 1825. 

i 476, 1882, i., 786. J 476, 1840-41, i.. 493. 

k 454, 1828. xxxi., 83-85. 1 Gaz. nied. de Nantes, 1883-4, ii., 39. 

m 789, 1872, xiv., 845. " Southern Jour, of Med. aud Pharm., Charleston, March, 1847. 

Plate i. 

" /-l 



Menstrviation from the breast (Baker). 


matter were made to exude. This discharge, however, was not offensive to 
the smell. On March 17, 1846, the breast became much enlarged and con- 
gested, as portrayed in Plate 1 (Fig. 1). The ulcer was much inflamed and 
painful, the veins corded and deep colored, and there was a free discharge 
of sanguineous yellowish matter. When the girl's general health improved 
and menstruation became more natural, the vicarious discharge diminished 
in proportion, and the ulcer healed shortly afterward. Every month this 
breast had enlarged, the ulcer became inflamed and discharged vicariously, 
continuing in this manner for a few days, with all the accompanying mens- 
trual symptoms, and then dried up gradually. It was stated that the ulcer 
was the result of the girl's stooping over some bushes to take an egg from a 
hen's nest, when the point of a palmetto stuck in her breast and broke off. 
The ulcer subsequently formed, and ultimately discharged a piece of pal- 
metto. This happened just at the time of the beginning of the luenstrual 
epoch. The accompanying figures, Plate 1 (Figs. 1, 2), show the breast in 
the ordinary state and at the time of the anomalous discharge. 

Hancock * relates an instance of menstruation from the left breast in a 
large, otherwise healthy. Englishwoman of thirty-one, who one and a half 
years after the birth of the youngest child (now ten years old) commenced 
to have a discharge of fluid from the left breast three days before the time 
of the regular period. As the fluid escaped from the nipple it became 
changed in character, passing from a whitish to a bloody and to a yellow- 
ish color respectively, and suddenly terminating at the beginning of the real 
flow from the uterus, to reappear again at the breast at the close of the flow, 
and then lasting two or three days longer. Some pain of a lancinating type 
occurred in the breast at this time. The patient first discovered her peculiar 
condition by a stain of blood upon the night-gown on awakening in the 
morning, and this she traced to the breast. From an examination it ap- 
peared that a neglected lacerated cervix during the birth of the last child 
had given rise to endometritis, and for a year the patient had suffered from 
severe menorrhagia, for which she was subsequently treated. At this time 
the menses became scanty, and then supervened the discharge of bloody fluid 
from the left breast, as heretofore mentioned. The right breast remained 
always entirely passive. A remarkable feature of the case was that some 
escape of fluid occurred from the left breast during coitus. As a possible 
means of throwing light on this subject it may be added that the patient 
was unusually vigorous, and during the nursing of her two children she had 
more than the ordinary amount of milk (galactorrhea), which poured from the 
breast constantly. Since this time the breasts had been quite normal, except 
for the tendency manifested in the left one under the conditions given. 

Cases of menstruation through the eyes are frequently mentioned by 
the older writers. Bellini,'^' Hellwig,^^^ and Dodonaeus all speak of menstrua- 

a533, 1895, May 11th. b Zodiacus, etc., 1680. 



tion from tlie ovo. Jonston^'" (luotes an exain])lo of ocular menstruation in 
a young 8axou girl, and Bartliolinus '•* an instance associated with bloody dis- 
charge of the foot. Guepin" has an example in a case of a girl of eighteen, 
who connnenced to menstruate when three years old. The menstruation 
was tolerably regular, occurring every thirty-two or thirty-three days, and 
lasting from one to six days. At the cessation of the menstrual How, she 
generally had a suj)plementarv epistaxis, and on one occasion, when this was 
omitted, she suffered a sudden cifii^ioii into the anterior chamber of the eye. 
The discharge had only lasted two hours on this occasion. He also relates an 
example of hemorrhage into the vitreous humor in a case of amenorrhea. 
Conjunctival hemorrhage has been noticed as a manifestation of vicarious 
menstruation by several American observers. Liebreich found exam])les of 
retinal hemorrhage in suppressed menstruation, and Sir James Paget'' says 
that he has seen a young girl at Moorfields who had a small effusion of 
blood into the anterior ehaml)er of the eye at the menstrual period, Avhich 
became ai>sorbed during the intervals of menstruation. Blair '^ relates the 
history oi a case of vicarious menstruation attended with conjunctivitis and 
opacity of the cornea. Law ^ speaks of a plethoric woman of thirty who 
bled freely from the eyes, though nienstraating regularly. 

Relative to menstruation from the ear, Spindler,® Paullini,^ and Ali- 
bert *'' furnish examples. In Paullini's case the discharge is spoken of as 
very foul, which makes it quite possil)le that this was a case of middle-ear 
disease associated with some menstrual disturbance, and not one of true 
vicarious menstruation. Alibert's case was consequent upon suppression of 
the menses. Law ^ cites an instance in a woman of twenty-three, in Avhom 
the menstrual discharge was suspended several months. She experienced 
fulness of the head and bleeding (largely from the ears), which subse- 
quently occurred periodically, being preceded by much throbbing ; but the 
patient finally made a good recovery. Barnes,' Stepanoif, J and Field ^ ad- > 
duce examples of this anomaly. Jouilleton ^ relates an instance of men- Y 
struation from the right ear for five years, following a miscarriage. 

Hemorrhage from the mouth of a vicarious nature has been frequently 
observed associated with menstrual disorders. The Ephemerides,^"^ Mei- 
bomius,^"^ and Rhodius mention instances. The case of Meibomius was that 
of an infant, and the case mentioned l)y Rhodius was associated Avith hemor- 
rhages from the lungs, umbilicus, thigh, and tooth-cavity. Allport'" reports 
the history of a case in which there was recession of the gingival margins 
and alveolar processes, the consequence of amenoprhea. Caso"^ has an in- 

al45, vol. xlvi. b 476, 1882, i., 78(i. 

c Oglethorpe Med. and Surg. Jour., Savannah, 1858-9, i., 11. 

d 224, 1869. e 743, n. 63. f 620, cent, iv., obs. 56. 

g Jour, (le Med. et Chir. de Toulouse, 1845-6. 1> 313, 1867. 

i 317, 1826-7. J 557, 1885, xxiv., 588-595. 1 536, xxiii., 115. 

1461,1813,330. w 4.50, 1885, iv., 147. n 538, 1878. 


stance of menstruation from the gums, and there is on record the description 
of a woman, aged thirty-two, who had bleeding from the throat preceding men- 
struation ; later the menstruation ceased to be regular, and four years pre- 
viously, after an unfortunate and violent connection, the menses ceased, and 
the woman soon developed hemorrhoids and hemoptysis. Henry ^ speaks of 
a woman who menstruated from the mouth ; at the necropsy 207 stones were 
found in the gall-bladder. Krishaber speaks of a case of lingual men- 
struation at the epoch of menstruation. 

Descriptions of menstruation from the extremities are quite numer- 
ous. Pechlin ^ offers an example from the foot ; Boerhaave from the skin 
of the hand ; Ephemerides ^°^ from the knee ; Albertus from the foot ; 
Zacutus Lusitanus ° from the left thumb ; Bartholinus '^ a curious instance 
from the hand ; and the Ephemerides ^ another during pregnancy from the 

Post^ speaks of a very peculiar case of edema of the arm alternating 
with the menstrual discharge. Sennert writes of menstruation from the 
groin associated with hemorrhage from the umbilicus and gums. Moses ^ 
offers an example of hemorrhage from the umbilicus, doubtless vicarious. 
Verduc details the history of two cases from the top of the head, and Kerck- 
ring'^ cites three similar instances, one of which was associated with hemor- 
rhage from the hand, 

A peculiar mode is vicarious menstrual hemorrhage through old 
ulcers, wounds, or cicatrices, and many examples are on record, a few of 
which will be described. Calder ' gives an excellent account of menstrua- 
tion at an ankle-ulcer, and BrinckenJ says he has seen periodical bleeding 
from the cicatrix of a leprous ulcer. In the Lancet'^ is an account of a case p^ 
in the Vienna Hospital of simulated stigmata ; the scar opened each month 
and a menstrual flow proceeded therefrom ; but by placing a plaster-of-Paris 
bandage about the wound, sealing it so that tampering with the wound could 
be easily detected, healing soon ensued, and the imposture was thus exposed. 
Such would likely be the result of the investigation of most cases of " bleed- 
ing wounds " which are exhibited to the ignorant and superstitious for relig- 
ious purposes. 

Hogg ' publishes a report describing a young lady who injured her leg 
with the broken steel of her crinoline. The wound healed nicely, but always 
burst out afresh the day preceding the regular period. Forster ™ speaks of 
a menstrual ulcer of the face, and Moses ° two of the head. White, quoted 
by Barnes, cites an instance of vicarious hemorrhage from five deep fissures 

a 663, 1757, 384. b 622, L. i. c 831, L. ix., obs. 13. 

d 190, cent, i., hist. 13. e 104, dec. i., ann. i., obs. 96. f 595, 1841, iv., 215. 

g 124, 1859. h 473, obs. 60, 85. i 527, 1735, iii., 380. 

J Christiania, 1834. k 476, 1879, i., 593. 1 476, 1885, ii., 515. 

ni 490, 1851, xlvii. n 124, 1859. 



of the lips in a girl of fourteen ; the hemorrhage was periodical and could 
not bo checked. At the advent of each menstrual period the lips became 
much congested, and the recently-healed menstrual scars burst open anew. 

Knaggs * relates an interesting account of a sequel to an operation for 
ovarian disease. Following the operation, there was a regular, painless 
menstruation every montli, at wliich time the lower part of the Avound re- 
opened, and blood issued Ibrtli during the three days of the catamenia. 
Medraw '' illustrates vicarioii- nuMistruatiou by an example, the discharge 
issuing from an ovariotomy-scar, and Hooper ^ cites an instance in which the 
vicarious function was performed by a sloughing ulcer. Buchanan •* and 
Simpson ^ describe '* amenorrheal ulcers." Diipuytren ^ speaks of denuda- 
tion of the skin from a burn, with the subsequent development of vicarious 
catamenia from the seat of the injury. 

There are cases on record in which the menstruation occurs by the 
rectum or the urinary tract. Barl)ee *'' illustrates this by a case in which 
cholera morbus occurred monthly in lieu of the regular menstrual discharge. 
Barrett*^ speaks of a case of vicarious menstruation by the rectum. Ast- 
bury ^^^ says he has seen a case of menstruation by the hemorrhoidal vessels, 
and instances of relief from plethora by vicarious menstruation in this 
manner are quite common. Rosenbladt ^^^ cites an instance of menstruation 
by the bladder, and Salmuth^ speaks of a pregnant woman who had her 
monthly flow by the urinary tract. Ford J illustrates this anomaly by 
the case of a woman of thirty-two, who began normal menstruation at four- 
teen ; for quite a period she had vicarious menstruation from the urinary 
tract, which ceased after the birth of her last child. The coexistence of a 
floating kidney in this case may have been responsible for this hemorrhage, 
and in reading reports of so-called menstruation due consideration must be 
given to the existence of any other than menstrual derangement before we 
can accept the cases as true vicarious hemorrhage. Tarnier cites an instance 
of a girl without a uterus, in whom menstruation proceeded from the vagina. 
Zacutus Lusitanus ^ relates the history of a case of uterine occlusion, with 
the flow from the lips of the cervix. There is mentioned an instance of 

/menstruation from the labia. 
The occurrence of menstruation after removal of the uterus or 
ovaries is frequently reported. Storer,' Clay,™ Tait," and the British and 
Foreign ]\Iedico-Chirurgical Review " report cases in which menstruation 
took place with neither uterus nor ovary. Doubtless many authentic 
instances like the preceding could be found to-day. Menstruation after 

a 310, 1873. b 125, 1884, 912-914. c 547, 1882-3. d 381, 1879. 

e Month. Jour. Med. Sci., Lond., 1855, xx., 347. f 363, 1828, i., 85. 

g 511, 1840. h 809, 1875. i 706, cent, iii., obs. 36. 

J 125, vol. xxii., 154. ^831, L. ix., ohs. 4. ' 476, 1866, ii., 471. 

m476, 1880, i., 15. 0543, 1884, i., 662. » 22, 1873, i., 296. 


hysterectomy and ovariotomy has been attributed to the incomplete removal 
of the organs in question, yet upon postmortem examination of some cases 
no vestige of the functional organs in question has l)een found. 

Hematemesis is a means of anomalous menstruation, and several 
instances are recorded. ]Marcellus Donatus °- and Benivenius ''-'^ exemplify 
this with cases. Instances of vicarious and compensatory epistaxis and 
hemoptvsis are so common that any examples would be superfluous. There 
is recorded'^ an inexplicable case of menstruation from the region of the 
sternum, and among the curious anomalies of menstruation must be men- 
tioned that reported by Parvin '^ seen in a woman, who, at the menstrual epoch, 
suffered hemoptysis and oozing of blood from the lips and tongue. Occa- 
sionally there was a substitution of a great swelling of the tongue, rendering 
mastication and articulation very difficult for four or five days. Parvin gives 
portraits showing the venous congestion and discoloration of the lips. 

Instances of migratory menstruation, the flow moving periodically 
from the ordinary passage to the breasts and mammae, are found in the older 
writers.*^ Salmuth speaks of a woman ® on Avhose hands appeared spots 
immediately before the establishment of the menses. Cases of semimonthly 
menstruation ^'^^ and many similar anomalies of periodicity are spoken of. 

The Epliemerides contains ' an instance of the simulation of menstrua- 
tion after death, and Testa s speaks of menstruation lasting through a long 
sleep. Instances of black menstruation are to be found, described in full, 
in the Ephemerides, by Paullini ^ and by Schurig,' and in some of the later 
works ; it is possible that an excess of iron, administered for some menstrual 
disorder, may cause such an alteration in the color of the menstrual fluid. 

Suppression of menstruation is brought about in many peculiar ways, 
and sometimes by the slightest of causes, some authentic instances being so 
strange as to seem mythical. Through the Ephemerides ^*^^ we constantly 
read of such causes as contact Avith a corpse, the sight of a serpent or mouse, 
the sight of monsters, etc. Lightning stroke and curious neuroses have been 
reported as causes. Many of the older books on obstetric subjects are full 
of such instances, and modern illustrations are constantly reported. 

Menstruation in Man. — Periodic discharges of blood in man, constitut- 
ing what is called " male menstruation," have been frequently noticed and 
are particularly interesting when the discharge is from the penis or urethra, 
furnishing a striking analogy to the female function of menstruation. Tlie 
older authors quoted several such instances, and Mehliss says that in the 
ancient days certain writers remarked that catamenial lustration from the 
penis was inflicted on the Jews as a divine punishment. Bartholinus J 

a 306, L. iv., 19. b 108, dec. i., vol. iv., 69. c 764, 1877. 

d 282, 1733, 359 : and 105, vol. iii., app., 168. e 706, cent, iii., obs. 18. 

f 104, dec. iii., ann. iv., obs. 18. g758, 215. li 620, cent, ii., obs. 8. 

i 724, 217. J 190, cent, v., hist. 33. 



iHcntiims a ease in a youth; the K|)licniorides several instances; Zacutus 
J^usitanus, Salniuth, •' I lauclorn, Fahririns Hildanus, Vesalius, '* Mead, '^ 
and Acta Ernditoriun '' all mention instances. Forol "^ saw menstruation in 





a man. iiiomiin'cr' tells ot" a man ol" t liirty-six, who, since the age of 
seventeen years and live months, had had lunar manifestations of menstrua- 
tion. Each attack was acc(>mj)anieil by pains in the back and hypogastric 
region, 'felirile disturbaiu'e, and a sanguineous discharge from the urethra, 
which i-eseml)led in color, consistency, etc., the menstrual flux. Kings'' re- 
lates that while attending a course of medical lectures at the University of 
Louisiana he formed the accjuaintauee of a young student who possessed the 
normal male generative organs, but in whom the simulated fiuiction of men- 
struation was periodically performed. The cause was inexplicable, and the 
unfortunate victim was the subject of deep chagrin, and was afflicted with 
melancholia. He had menstruated for three years in this manner : a fluid 
exuded from the sebaceous glands of the deep fossa behind the corona 
glandis ; this fluid was of the same appearance as the menstrual flux. The 
quantity was from one to two ounces, and the discharge lasted from three to 
six days. At this time the student was twenty-two years of age, of a 
lymphatic temperament, not particularly lustful, and was never the victim 
of any venereal disease. The author gives no account of the after-life of 
this man,' his whereabouts being, unfortunately, unknown or omitted. 

Vicarious Menstruation in the Male. — This sinmlation of menstrua- 
tion by the male assumes a vicarious nature as well as in the female. Van 
Swieten,'"' quoting from Benivenius, relates a case of a man who once a month 
sweated great ([uantities of blood from his right flank. Pinel mentions a 
case of a cajitain in the army (M. Regis), who was wounded by a bullet in 
the body and ^vho afterward had a monthly discharge from the lu'cthra. 
Pinel calls attention particularly to the analogy in this case by mentioning 
that if the captain were exposed to fatigue, privation, cold, etc., he exhibited 
the ordinary symptoms of amenorrhea or siqipression. Fournier^ speaks of 
a man over thirty years old, who had been the subject of a menstrual evacua- 
tion since puberty, or shortly after his first sexual intercourse. He would 
experience pains of the premenstrual type, about twenty-four hours before 
the appearance of the flow, which subsided when the menstruation began. 
He was of an intensely voliq)tuous nature, and constantly gave himself up to 
sexual excesses. The flow was abimdant on the first day, diminished on the 
second, and ceased on the third. Halliburton,' Jouilleton, and Kavman also 
record male menstruation. 

Cases of menstruation during pregnancy and lactation are not rare. 

" 7(lG, cent, iii., obs. 47. 
d 106, ann. 168S,, 228. 
g 251, 1867. 
i 302, iv., 192. 

t>803, L. v., tap. 15. c 515^ 369. 

e 239, 1869. fl29, 1819. 

h 755, vol. xiii., sect, 1286. 
J Weekly Metl. Rev., Chicago, 1884, xii., 392. 


It is not uncommon to find pregnancy, lactation, and menstruation coexist- 
ing. No careful obstetrician will deny pregnancy solely on the regular 
occurrence of the menstrual periods, any more than he would make the diag- 
nosis of pregnancy from the fact of the suppression of menses. Blake ^ 
reports an instance of catamenia and mammary secretion during pregnancy. 
Denaux de Breyne mentions a similar case. The child was born by a face- 
presentation. De Saint-Moulin '^ cites an instance of the persistence of men- 
struation during pregnancy in a woman of twenty-four, who had never been 
regular ; the child was born at term. Gelly speaks of a case in w^hich 
menstruation continued until the third month of pregnancy, when abortion 
occurred. Post,^ in describing the birth of a two-pound child, mentions 
that menstruation had persisted during the mother's pregnancy. Rousset** 
reports a peculiar case in which menstruation appeared during the last four 
months of pregnancy. 

There are some cases on record of child-bearing after the menopause, 
as, for instance, that of Pearson,® of a woman who had given birth to nine 
children up to September, 1836 ; after this the menses appeared only slightly 
mitil July, 1838, when they ceased entirely. A year and a half after this 
she was delivered of her tenth child. Other cases, somewhat similar, will 
be found under the discussion of late conception. 

Precocious menstruation is seen from birth to nine or ten years. Of 
course, menstruation before the third or fourth year is extremely rare, most 
of tlie cases reported before this age being merely accidental sanguineous 
discharges from the genitals, not regularly periodical, and not true catamenia. 
However, there are many authentic cases of infantile menstruation on record, 
which were generally associated with precocious development in other parts as 
well. Billard says that the source of infantile menstruation is the lining 
membrane of the uterus ; but Camerer explains it as due to ligature of the 
umbilical cord before the circulation in the pulmonary vessels is thoroughly 
established. In the consideration of this subject, we must bear in mind the 
influence of climate and locality on the time of the appearance of menstruation. 
In the southern countries, girls arrive at maturity at an earlier age than 
their sisters of the north. Medical reports from India show early puberty 
of the females of that country. Campbell remarks that girls attain the age 
of puberty at twelve in Siam, while, on the contrary, some observers report 
the fact that menstruation does not appear in the Esquimaux women until 
the age of twenty-three, and then is very scanty, and is only present in the 
summer months. 

Cases of menstruation commencing within a few days after birth and 
exhibiting periodical recurrence are spoken of by Penada,^ Neues Han- 

a218, 1856-7, Iv., 508. b Jour, d'accouch., Liege, 1888, ix., 205. 

C286, 1885-6, i., 543. d jour. de med. de Bordeaux, 1856. 

e 476, 1836. f Saggio d'osservazioni, iii. 


novcrischcs Matra>''in," Drummoncl/' Biixtorf,'" Arnold/^ The Lancet/ and 
the JJritisli Medical Jcnirnnl. ^ 

CVoil ^' rehites :ui instanoo ot" menstruation on tlio sixth day, continuing 
for five davs, in wliich .-i\ or cii^ht dninis of hlood were lost. Peeples^ 
cites an instance in Texas in an infant at the age of five days, -which Avas 
associated with a reniarkaliir deveiojuuent of the genital organs and breasts. 
Van Swieten otl'ers an exainph- at the first month ; the British Medical 
Journal ' at the second month ; C'onarmoud at the third month. Ysabel, a 

\J young shive girl belonging to Don Carlos Pedro of Havana,-* began to 
menstruate soon after birth, and at the first year was regular in this function. 
.\t birth lur iiiannu;e were well (U'veh»])ed and her axilhe were slightly cov- 
ered witii hair. .Vt tiie age of thirty-two months she was three feet ten 
inches tall, and her genitals and mannnae resembled those of a girl of thir- 
teen. Her voice was grave and sonorous ; her moral inclinations were not 
known. Deever'^^^ records an instance of a child two years and seven 
months old who, with the exception of three months only, had menstruated 
regularly since the fourth month. Harle '^ sjjeaks of a child, the youngest 
of three girls, who had a bloody discharge at the age of five months which 
lasted three days and recurred every month until the child was weaned at the 
tenth month. At the eleventh month it returned and continued periodically 
until death, occasioned by diarrhea at the fourteenth mouth. The necropsy 
showed a uterus 1 f inches long, the li])s of which were congested ; the left 
ovary was tAvice the size of the right, but displayed nothing strikingly 
abnormal. Baillot and the British Medical Journal • cite instances of men- 
struation at the fourth month. A case is on record"' of an infant who menstru- 
ated at the age of six months, and whose menses returned on the twenty- 
eighth day exactly. Clark, Wall, and the Lancet" give descriptions of cases 
at the ninth month. Naegele has seen a case at the eighteenth month, and 
Schmidt and Colly " in the second year. Another case^ is that of a child, 
nineteen months old, whose breasts and external genitals were fully de- 
veloped, although the child had shown no sexual desire, and did not exceed 
other children of the same age in intellectual development. This prodigy 
was symmetrically formed and of pleasant ap|)earance- Warner 'i speaks of 

\ Sophie Gantz, of Jewish jxirentage, born in Cincinnati, July 27, 1865, 

whose menses began at the twenty-third month and had continued regularly 

r up to the time of reporting. At the age of three years and six months 

y she was 38 inches tall, 38 pounds in weight, and her girth at the hip was 

33| inches. The pelvis was broad and well shaped, and measured lOJ 

a 586, xvii., 1519. t> 224, 1879, ii., 47. c 107, vol. vii., 107. 

d 494, 1876, ii., 42. e 476, 1871, i., 366. f 224, 1879, i, 841. 

g 494, 1885. h597, March, 1895. i 224, 1881, ii., 682. 

J 599, 1829. k224, 1880, i., 848. • 224, 1883, ii., 1141. ^224, 1879, i., 801. 

n 476, 1827. o 548, 1864, 382. P516, 1828. q 459, 1869. 


inches from the anterior surface of the spinous process of one ilium to that 
of the other, being a little more than the standard pelvis of Churchill, and, 
in consequence of this pelvic development, her legs were bowed. The 
mamniffi and labia had all the appearance of established puberty, and the 
pubes and axillse were covered with hair. She was lady-like and maidenly 
in her demeanor, without unnatural constraint or effrontery. A case some- 
what similar, though the patient had the appearance of a little old woman,'^ was 
a child of three whose breasts were as well developed as in a girl of twenty, 
and whose sexual organs resembled those of a girl at puberty. She had 
menstruated regularly since the age of two years. Woodruff'' describes a 
child who l)egan to menstruate at two years of age and continued regularly 
thereafter. At the age of six years she was still menstruating, and exhibited 
beginning signs of puberty. She was 118 cm. tall, her breasts were devel- 
oped, and she had hair on the mons veneris. Van der Veer ° mentions an 
infant who began menstruating at the early age of four months and had 
continued regularly for over two years. She had the features and develop- 
ment of a child ten or twelve years old. The external labia and the vulva 
in all its parts were well formed, and the mons veneris was covered with a 
full growth of hair. Sir Astley Cooper, Mandelshof, the Ephemerides, 
Rause, Geoffroy-Saint-Hilaire, and several others'^ report instances of 
menstruation occurring at three years of age, Le Beau ® describes an infant- 
prodigy who was born with the mammse well formed and as much hair on 
the mons veneris as a girl of thirteen or fom'teen. She menstruated at three 
and continued to do so regularly, the flow lasting four days and l)eing 
copious. At the age of four years and five months she was 421 inches tall ; 
her features were regular, the complexion rosy, the hair chestnut, the eyes 
blue-gray, her mammre the size of a large orange, and indications that she 
would be able to bear children at the age of eight. Prideaux cites a case at 
five, and Gaugirau Casals, a doctor of Agde, ^ has seen a girl of six years 
who suffered abdominal colic, hemorrhage from the nose, migraine, and neu- 
ralgia, all periodically, which, with the association of pruritus of the genitals 
and engorged mammse, led him to suspect amenorrhea. He ordered baths, 
and shortly the menstruation appeared and became regular thereafter. 
Brierre de Boismont records cases of catamenia at five, seven, and eight 
years ; and Skene ^ mentions a girl who menstruated at ten years and five 
months. She was in the lowest grade of society, living Avith a drunken 
father in a tenement house, and was of wretched physical constitution, quite 
ignorant, and of low moral character, as evinced by her specific vaginitis. 
Occurring from nine years to the ordinary time of puberty, many cases are 

a 476, Jan. 29, 1848, 137. b 538, March 7, 1896. <= 125, 1883. 

d 458, Jan,, 1811, 115 ; 468, 1809, ix., 96 ; and 109, iv,, 44. e 124, 1832, xi., 42. 

f 302, iv,, 203, S 738, 49., 


Instances of protracted menstruation are, as a rule, reliable, the indi- 
viduals themselves being cognizant of the nature of true menstruation, and 
themselves furnishing the requisite information as to the nature and perio- 
dicity of the discharge in question. Such cases range even past the century- 
mark. Many elaborate statistics on this subject have been gathered by men 
(A' ability. Dr. Meyer of Berlin quotes the following : — 


28 at 50 years of age, 

3 at 57 

yeai-s of age, 

18 "51 " " " 

3 "58 

18 "52 " " " 

1 " 59 

11 "53 " " " 

4 "60 

13 "54 " " " 

4 " 62 

5 "55 " " " 

Z "63 

4 " 56 " " " 

These statistics were from examination of 6000 cases of menstruating 
women. The last seven were found to be in women in the highest class of 

Mehliss has made the following collection of statistics of a somewhat sim- 
ilar nature : — 

Late Dentition. Late Late 

Male. Female. Lactation. Menstruation. 

Between 40 and 50 4 

" 50 " 60 1 4 2 1 

" 60 " 70 3 2 1 

" 70 " 80 3 2 7 

80 " 90 6 2 

" 90 " 100 1 1 1 

Above 100 6 1 1 

20 16 3 10 

These statistics seem to have been made with the idea of illustrating the 
marvelous rather than to give the usual prolongation of these functions. It 
hardly seems possible that ordinary investigation would show no cases of 
menstruation between sixty and seventy, and seven cases between seventy 
and eighty ; however, in searching literature for such a collection, we must 
bear in mind that the more extraordinary the instance, the more likely it is 
that it would l)e spoken of, as the natural tendency of medical men is to 
overlook the important ordinary and report the nonimportant extraordinary. 

Dewees mentions an example of menstruation at sixty-five, and others at 
fifty-four and fifty-five years. Motte speaks of a case at sixty-one ; Ryan and 
others, at fifty-five, sixt}', and sixty-five ; Parry, from sixty-six to seventy- 
seven ; Desormeux, from sixty to seventy-five ; Semple, at seventy and eighty- 
seven ; Higgins,'* at seventy-six ; Whitehead,'' at 'seventy-seven ; Bernstein, 
at seventy-eight ; Beyrat,'' at eighty-seven ; Haller, at one hundred ; and high- 
est of all is Blancardi's case, in which menstruation was present at one hun- 
dred and six years. In the London Medical and Surgical Journal, 1831, are 
reported cases at eighty and ninety-five years. In Good's System of Nosol- 

a476, 1883, i., 485. b 543, 1866, i., 407. c 147^ aou. xiii. 


ogy^^^ there are instances occurring at seventy-one, eighty, and ninety years. 
There was a woman in Italy whose menstrual function continued from twen- 
ty-four to ninety years." Emmet ^ cites an instance of menstruation at 
seventy, and Brierre de Boismont one of a woman who menstruated regu- 
larlv from her twenty-fourth year to the time of her death at ninety-two. 

Strasberger of Beeskow describes a woman who ceased menstruating at 
forty-two, who remained in good health up to eighty, suffering slight attacks 
of rheumatism only, and at this late age was seized with abdominal pains, 
followed by menstruation, which continued for three years; the woman died 
the next year. This late menstruation had all the sensible characters of the 
early one. Kennard ^ mentions a negress, aged ninety-one, who menstruated 
at fourteen, ceased at forty-nine, and at eighty-two commenced again, and 
was regular for four years, but had had no return since. On the return of her 
menstruation, believing that her procreative powers were returning, she mar- 
ried a vigorous negro of thirty-five and experienced little difficulty in satisfying 
his desires. Du Peyrou de Cheyssiole and Bonhoure '^ speak of an aged peas- 
ant woman, past ninety-one years of age, who menstruated regularly. 

Petersen ^ describes a woman of seventy-nine, who on March 26th was 
seized with uterine pains lasting a few days and terminating with hemor- 
rhagic discharge. On April 23d she was seized again, and a discharge com- 
menced on the 25th, continuing four days. Up to the time of the report, 
one year after, this inenstruation had been regular. There is an instance on 
record of a female who menstruated every three months during the period 
from her fiftieth to her seventy-fourth year, the discharge, however, being 
very slight. Thomas^ cites an instance of a woman of sixty-nine who had 
had no menstruation since her forty-ninth year, but who commenced again the 
year he saw her. Her mother and sister were similarly affected at the age 
of sixty, in the first case attributable to grief over the death of a son, in the 
second ascribed to fright. It seemed to be a peculiar family idiosyncrasy. 
Velasquez of Tarentum » says that the Abbess of Monvicaro at the very 
advanced age of one hundred had a recurrence of catamenia after a severe 
illness, and subsequently a new set of teeth and a new growth of hair. 

Late Establishment of Menstruation. — In some cases menstruation 
never appears until late in life, presenting the same phenomena as normal 
menstruation. Perfect^ relates the history of a woman who had been mar- 
ried many years, and whose menstruation did not appear until her forty- 
seventh year. She was a widow at the time, and had never been pregnant. 
Up to the time of her death, which was occasioned by a convulsive colic, in 
her fifty-seventh year, she had the usual prodromes of menstruation followed 
by the usual discharge. Rodsewitch^ speaks of a widow of a peasant who 

a 124,vol. vii., o. s., 514. b 125, 1886, 152. c 519, 1871. 

d280, 1787, xiv., 32. e 207, Feb., 1840. f546, 1852, 148. 

g 222, 1840 (translation). h 564, vol. iii., 593. i 811, 1879. 



menstruated for the first time at the ajje of thirty-six. Her first coitus took 
phico at the ai>e of fifteen, before any signs of menstruation had appeared, 
and from this time all throuo-h her married life she was either pregnant or 
suckling. Her hushand died when thirty-six years old, and ever since the 
eatamenial fiow had shown itself with great regularity. She had borne 
twins in her second, fourth, and eighth confinement, and altogether had 16 
children. Holdefrund in ISKj mentions a case in which menstruation did 
not conunencc until the -tviiitieth year, and Hover ^ mentions one delayed 
to the seventy-sixth year. Marx of Krakau'' speaks of a Avoman, aged 
forty-eight, wIk^ had never menstruated ; until forty-two years old she had 
felt no symi)t(tms, but at this time pain be^an, and at fort\'-eight regular 
menstruation ensued. At the time of report, four years after, she was free 
from pain and amenorrhea, and her flow vas regular, though scant. She 
had been married since she was twenty-eight years of age. A somew^hat 
similar ease is mentioned by Gregory' *^ of a mother of 7 children Avho 
had never had her menstrual flow. There are two instances of delayed 
menstruation quoted : '^ the first, a woman of thirty, well formed, healthy, of 
good social position, and with all the signs of puberty except menstruation, 
which liad never appeared ; the second, a married Avoman of forty-two, who 
throughout a healthy connubial life had never menstruated. An instance is 
known to the authors of a woman of forty wdio has never menstruated, though 
she is of exceptional vigor and development. She has been married many 
years without pregnancy. 

The medical literature relative to precocious impregnation is full of 
marvelous instances. Individually, many of the cases would be beyond 
credibility, but when instance after instance is reported by reliable authori- 
ties we must accept the possibility of their occurrence, even if we doubt 
the statements of some of the authorities. No less a medical celebrity tlian 
tlie illustrious Sir Astley Cooper remarks that on one occasion he saw a 
girl in Scotland, seven years old, whose pelvis was so fully developed that 
he was sure she could easily give birth to a child ; and Warner's case of the 
Jewish girl three and a half years old, with a pelvis of normal width, more 
than substantiates this supposition. Similar examples of precocious pelvic 
and sexual development are on record in abundance, and nearly every medi- 
cal man of experience has seen cases of infantile masturbation. 

The ordinary period of female matiu'ity is astonishingly late when com- 
])ared with the lower animals of the same size, ]>articularly when viewed 
with cases of animal precocity on record. Berthohb' speaks of a kid four- 
teen days old which was impregnated by an adult goat, and at the usual 
period of gestation bore a kid, w^hich was mature but weak, to which it gave 
vj milk in abundance, and Vioth the mother and kid grew up strong. Compared 
with the above, child-bearing by women of eight is not extraordinary. 

a 108, 1712. 1^657,1889,9. 024,1853. d 302, i v., 193. e 202, 32. 


The earliest case of conception that has come to the authors' notice is a 
quotation in one of the last century books from von Mandelslo'' of impreg^- 
nation at six ; but a careful search in the British Museum failed to confirm 
this statement, and, for the present, we must accept the statement as hearsay 
and without authority available for reference-purposes. 

Molitor ^ gives an instance of precocious pregnancy in a child of ^ight. 
It was probably the same case spoken of by Lefebvre '^ and reported to the 
Belgium Academy : A girl, born in Luxemborg, well developed sexually, 
having hair on the pubis at birth, who menstruated at four, and at the age 
of eight was impregnated by a cousin of thirty-seven, who was sentenced to 
five years' imprisonment for seduction. The pregnancy terminated by the 
expulsion of a mole containing a well-characterized human embryo. 
Schmidt's case in 1779 '^ was in a child who had menstruated at two, and 
bore a dead fetus when she was but eight years and ten months old. She 
had all the appearance and development of a girl of seventeen. Kussmaul 
gives an example of conception at eight. Dodd*^ speaks of a child who 
menstruated early and continued up to the time of impregnation. She was a 
hard worker and did all her mother's washing. Her labor pains did not 
continue over six hours, from first to the last. The child was a large one, 
weighing 7 pounds, and afterward died in convulsions. The infant's left 
foot had but 3 toes. The young mother at the time of delivery was only 
nine years and eight months old, and consequently must have been impreg- 
nated before the age of nine. Meyer gives an astonishing instance of birth in 
a Swiss girl at nine. Cam describes a case of a child who menstruated at two, 
became pregnant at eight, and lived to an advanced age. Ruttel reports con- 
ception in a girl of nine, and as far north as St. Petersburg a girl has become 
a mother before nine years. The Journal de Sgavans, 1684,^"'' contains the 
report of the case of a boy, who survived, being born to a mother of nine 

Beck has reported an instance of delivery in a girl a little over ten years 
of age. There are instances of fecundity at nine years recorded by Ephemeri- 
des, Wolffius,^ Savonarola,^ and others.^ Gleaves ' reports from Wytheville, 
Va., the history of what he calls the case of the youngest mother in Virginia 
— Annie H. — who was born in Bland County, July 15, 1885, and, on Sep- 
tember 10, 1895, was delivered of a well-formed child weighing 5 pounds. 
Tlie girl had not the development of a woman, although she had menstruated 
regularly since her fifth year. The labor was short and uneventful, and, two 
hours afterward, the child-mother wanted to arise and dress and would have 
done so had she been permitted. There were no developments of the 
mamnife nor secretion of milk. The baby was nourished through its short 

a 505. b 171, 1878-9. c 362, March 8, 1878* 

d753, vol. ii. e 476, 1881, i., 601. f Lect. Memorabilis, T. i., 620. 

g 714, cap. 21, n. 6. ^ 458, T. xxxvii., 542. i 538, Nov. 16, 1895. 


existence (as it only lived a week) by its grandmother, Avho had a child only 
a few months old. The })arents of this child were prosperous, intelligent, and 
worthy people, and there was no doubt of the child's age. " Annie is now 
well and plays about witii the other children as if nothing had happened." 
Harris refers to a Kentucky woman, a mother at ten years, one in Massachu- 
setts a mother at ten years, eight months, and seventeen days, and one in Phila- 
delphia at eleven years and three months. The first case was one of infantile 
precocity, the other belonging to a nmch later period, the menstrual function 
having been established but a few months prior to conception. All these 
girls had well-developed pelves, large mamma?, and the general marks of 
womanhood, and bore living children. It has been remarked of 3 xery 
markedly precocious cases of pregnancy that one was the daughter of very 
humble parents, one born in an almshouse, and the other raised by her mother 
in a house of prostitution. The only significance of this statement is the 
greater amount of vice and opportunity for precocious sexual intercourse to 
which they were exposed ; doubtless similar cases under more favorable con- 
ditions would never be recognized as such. 

The instance in the Journal deSgavans is reiterated in 1775,'* which is but 
sucli a repetition as is found all through medical literature — " new friends 
with old faces," as it were. Haller observed a case of impregnation in a 
girl of nine, who had menstruated several years, and others who had become 
pregnant at nine, ten, and twelve years respectively. Rowlett,'' whose case 
is mentioned by Harris, saw a child who had menstruated the first year 
and regularly thereafter, and gave birth to a child weighing 7f pounds 
when she was only ten years and thirteen days old. At the time of delivery 
she measured 4 feet 7 inches in height and weighed 100 pounds. Curtis,*^ 
who is also quoted by Harris, relates the history of Elizabeth Drayton, who 
became pregnant before she was ten, and was delivered of a full-grown, 
living male child weighing 8 pounds. She had menstruated once or twice 
before conception, was fairly healthy during gestation, and had a rather 
lingering but natural labor. To complete the story, the father of this child 
was a boy of fifteen. One of the faculty of Montpellier '^ has reported an 
instance at Xew Orleans of a yoimg girl of eleven, who became impregnated 
by a youth who was not yet sixteen. IMaygrier ^ says that he knew a girl 
of twelve, living in the Faubourg Saint-Germain, who w'as confined. 

Harris '^ relates the partieulars of the case of a white girl who began to 
menstruate at eleven years and four months, and who gave birth to an over- 
sized male child on January 21, 1872, when she' was twelve years and nine 
months old. She had an abundance of milk and nursed the child ; the labor 
was of about eighteen hours' duration, and laceration was avoided. He also 
speaks of a mulatto girl, born in 1848, who began to menstruate at eleven 

a 280, 1775. ^ 7S3, vol. vii. c 218, Feb. 19, 1863. 

d302, xxxii., .394. e ibid. f 125, 1874. 


years and nine months, and gave birth to a female child before she reached 
thirteen, and bore a second child when fourteen years and seven months old. 
The child's father was a white boy of seventeen. 

The following are some Indian statistics : * 1 pregnancy at ten, 6 at eleven, 
2 at eighteen, 1 at nineteen.'' Chevers -*''' speaks of a mother at ten and 
others at eleven and twelve ; and Green, at Dacca, performed craniotomy 
upon the fetus of a girl of twelve. Wilson ^ gives an account of a girl 
thirteen years old, who gave birth to a full-grown female child after three 
hours' labor. She made a speedy convalescence, but the child died four 
weeks afterward from bad nursing. The lad who acknowledged paternity 
was nineteen years old. King'^ reports a well- verified case of confinement 
in a girl of eleven. Both the mother and child did well. 

Robertson of Manchester describes a girl, working in a cotton factory, 
who Avas a mother at twelve ; de La ]\Iotte ^'^ mentions pregnancy before 
twelve ; Kilpatrick " in a negress, at eleven years and six months ; Fox,^ at 
twelve ; Hall,^ at twelve ; Kinney,** at twelve years, ten months, and sixteen 
days ; Herrick,' at thirteen years and nine months ; Murillo,J at thirteen years ; 
Philippart,*^ at fourteen years ; Stallcup, at eleven years and nine months ; 
Stoakley,* at thirteen years ; AValker,'" at the age of twelve years and eight 
months ; another case," at twelve years and six months ; and Williams," at 

a An editorial article in the Indian Medical Gazette of Sept., 1890, says : — 

"The appearance of menstruation is held by the great majority of natives of India to 
be evidence and proof of marriageability, but among the Hindu community it is considered 
disgraceful that a girl should remain unmarried until this function is established. The con- 
sequence is that girls are married at the age of nine or ten years, but it is understood or pro- 
fessed that the consummation of the marriage is delayed until after the first menstrual period. 
There is, however, too much reason to believe that the earlier ceremony is very frequently, 
perhaps commonly, taken to warrant resort to sexual intercourse before the menstrual flux 
has occurred : it may be accepted as true that premenstrual coi)nlation is largely practised 
under the cover of marriage in this country. 

" From this practice it results that girls become mothers at the earliest possible period 
of their lives. A native medical witness testified that in about 20 per cent, of marriages 
children were born by wives of from twelve to thirteen years of age. Cases of death caused 
by the first act of sexual intercourse are by no means rare. They are naturally concealed, 
but ever and anon they come to light. Dr. Chevers mentioned some 14 cases of this sort in 
the last edition of his 'Handbook of Medical Jurisprudence for India,' and Dr. Harvey 
found 5 in the medicolegal returns submitted by the Civil Surgeons of the Bengal Presidency 
during the years 1870-71-72. 

"Reform must come from conviction and effort, as in every other case, but meantime the 
strong arm of the law should be put forth for the protection of female children from the 
degradation and hurt entailed by premature sexual intercourse. This can easily be done by 
raising the age of punishable intercourse, which is now fixed at the absurd limit often years. 
Menstruation very seldom appears in native girls before the completed age of twelve years, 
and if the 'age of consent' were raised to that limit, it would not interfere with the preju- 
dices and customs which insist on marriage before menstruation." 

'>434, Feb., 1845. c 318, 1861-2. d 476, 1868, ii., 618. e 545, 1873. 

f 286, 1889. g 729, 1859. h 538, 1885. i 593, 1873. .i 668, 1875. 

kl43, 1875. 1 526, 1855, xi., 203. ^218, 1846-7. ^ 822, 1876. o 131, 1874. 


J 11 ISK) some jrirls were admitted to tlio Paris ^raternite as young as 
thirteen, and during the RevoUition several at eleven, and even younger. 
ISiuith '•'■ sj)eaks of a leg*al case in whieh a girl, eleven years old, being 
safely delivered of a living child, charged her uncle witli nii»e. Allen ^ speaks 
of a girl who hccaiiic pregnant at twelve years and nine months, and was 
delivered of a healthy, H-pound hoy before the physician's arrival; the 
])lacenta came away afterwiird, and the mother made a speedy recovery. 
Shi' was thought to have h;iU '' dropsy of the abdomen," as the parents had 
lost a girl of about the same age who was tajiped for ascites. The father of 
the child was a boy only fourteen years of age. 

jMarvelous to relate, there are on record several cases of twins l)eing born 
to a child mother. Kay reports a case of twins in a girl of thirteen ; 
Montgomery, at i'ourteen ; and Meigs reports the case of a young girl, of 
Spanish blood, at ^laracaibo, who gave birth to a child before she was 
twi'lvc and to twins before reaching fourteen years. 

In the older works, the following authors have reported cases of preg- 
nancy before the appearance of menstruation : Ballonius, Vogel, ^lor- 
gagni, the anatomist of the kidney, Schenck, Bartholinus, Bierling, Zacchias, 
Charleton, ^lauriccau, Ephemerides, and Fabricius Hildanus. 

In some cases this precocity seems to be hereditary, being transmitted 
from mother to daughter, bringing about an almost incredible state of affairs, 
in which :; girl is a grandmother about the ordinary age of maternity. Kay 
says that he had reported to him, on " pretty good " authority, an instance 
of a Damascus Jewess who became a grandmother at twenty-one years. In 
France '^ they record a young grandmother of twenty-eight. Ketclium ^ 
speaks of a negress, aged thirteen, who gave birth to a well-developed child 
wliich began to menstruate at ten years and nine months and at thirteen 
liecame ])regnant ; hence the negress was a grandmother at twenty-tive years 
and nine months. She had a second child before she was sixteen, who began 
to menstruate at seven years and six months, thus proving the inheritance of 
this precocity, and leaving us at sea to figure what degree of grandmother 
she may be if she lives to an advanced age. Another interesting case of 
this nature is that of Mrs. C,® born 1854, married in 1867, and who had a 
daughter ten months after. This daughter married in 1882, and in March, 
1883, gave birth to a 9-pound boy. The youthful grandmother, not twenty- 
niue, was present at the l)irth. This case was remarkable, as the children 
were both legitimate. 

Fecundity in the old seems to have attracted fully as much attention 
among the older oljservers as precocity. Pliny ^^^ speaks of Cornelia, of the 
family of Serpios, who bore a son at sixty, who was named Volusius 
Saturnius ; and Marsa, a jihysician of Venice, was deceived in a pregnancy 

a 490, 1H48. b 224^ 1885, ii., 913. c 365, 1867, No. 291. 

d 770, 1849. e 494, June 9, 1883. 


in a woman of sixty, his diagnosis being " dropsy." Tarenta records the history 
of the case of a woman who menstruated and bore children when past the 
age of sixty. Among tlie older reports are those of Blanchard ^ of a woman 
who bore a child at sixty years ; Fielitz/*5o one at sixty ; Ephemerides, one 
at sixty-two ; Rush,^ one at sixty ; Bernstein,^'^^ one at sixty years ; Schoepfer, 
at seventy years ; and, almost beyond belief, Debes ^ cites an instance as tak- 
ing place at the very advanced age of one hundred and three. Wallace '^ 
speaks of a woman in the Isle of Orkney bearing children when past the age 
of sixty. AVe would naturally expect to iind the age of child-bearing prolonged 
in the northern countries where the age of maturity is later. Capuron cites 
an example of child-birth in a woman of sixty ; Haller, cases at fifty-eight, 
sixty-three, and seventy ; Dewees, at sixty-one ; and Thibaut de Chauvalon, 
in a woman of Martinique aged ninety years. There was a woman delivered 
in Germany, in 172o, at the age of fifty-five ; one at fifty-one in Kentucky ; ^ 
and one in Russia at fifty. ^ Depasse^ speaks of a woman of fifty-nine years 
and five months old who was delivered of a healthy male child, which she 
suckled, Aveaning it on her sixtieth birthday. She had been a widow for 
twenty years, and had ceased to menstruate nearly ten years before. In St. 
Peter's Church, in East Oxford, is a monument bearing an inscription re- 
cording tlie death in child-birth of a woman sixty-two years old. Cachot'* 
relates the case of a woman of fifty-three, who was delivered of a living 
child by means of the forceps, and a year after bore a second child without 
instrumental interference. She had no milk in her breasts at the time and 
no signs of secretion. This aged mother had been married at fifty -two, five 
years after the cessation of her menstruation, and her husband M^as a young 
man, only twenty-four years old. 

Kennedy^ reports a delivery at sixty-two years, and the Cincinnati 
Enquirer, January, 1863, says : *' Dr. W. McCarthy was in attendance on a 
lady of sixty-nine years, on Thursday night last, who gave birth to a fine boy. 
The father of the child is seventy-four years old, and the mother and child 
are doing well." Quite recently there died in Great Britain a Mrs. Heniy^-^"^ 
of Gortree at the age of one hundred and twelve, leaving a daughter of nine 

MayhamJ saw a woman seventy-three years old w^ho recovered after 
delivery of a child. A most peculiar case is that of a widow, seventy years ^X^ 
old, a native of Garches."^ She had been in the habit of indulging freely in 
wine, and, during the last six months, to decided excess. After an unusually 
prolonged libation she found herself unable to walk home ; she sat down by 
the roadside waiting until she could proceed, and was so found by a young 
man who knew her and who proposed helping her home. By the time her 

a 213, cent, iv., u. 71. >> 696, ii. c 090, 043. d 629, vol. xxii. , 543. 
e 133, 1872, vi., 138. f 811, 1881, vi. g 364, Oct. 1, 1891. 

li 616, 1883-4, xxvi., 394. i 769, 1881. J 542, Jan., 1891. k 739, Dec. 3, 1881. 


house was rcacluHl n\^^\\{ was well atlvaiiccd, and slic invited him to stop over 
iiiii'lit ; tindiiio- lier more than att'abk', he stop])ed at her liouse over four nights, 
anil the resuh of" his visits was an ensuing pregnancy for Madame. 

Multiple births in the aged have been reported from authentic sources. 
The Lancet * quotes a rather fabulous account of a lady over sixty-two years 
of age who gave birth to tri]>lets, making her total number of children 
l.'l. Montgomery, Colomb, and Kneiiel, each, have recorded the birth of 
twins ill women beyond the usuid age of the menopause, and there is a case ^ 
recorded of a woman oi" fii'ty-two wh(> was <h'livered of twins. 

Impregnation without completion of the copulative act by reason 
of some malformation, such as occlusion of ihe vagina or uterus, fibrous and 
iinru]>tured hymen, etc., has been a subject of discussion in the works of 
medical jurisprudence of all ages; and cases of conception without entrance 
of the penis are found in abundance throughout medical literature, and may 
have an imjxirtant medicolegal bearing. There is little doubt of the possibility 
of spermatozoa deposited on the genitalia making progress to the seat of fer- 
tilization, as their power of motility and tenacity of life have been well dem- 
onstrated. Percy ° reports an instance in which semen was found issuing 
from the os uteri eight and one-half days after the last intercourse ; and a 
microscopic examination of this semen revealed the presence of living as well 
as dead sj^ermatozoa. \\e have occasional instances of impregnation by 
rectal coitus, the semen finding its way into an occluded vaginal canal by a 
fistulous communication. 

Guillemeau,'^ the surgeon of the French, king, tells of a girl of eighteen, 
who was brought before the French officials in Paris, in 1607, on the cita- 
tion of her husband of her inability to allow him completion of the marital 
function. He alleged that he had made several unsuccessful attempts to 
enter her, and in doing so had caused paraphimosis. On examination l)y 
the surgeons she was found to have a dense membrane, of a fibrous nature, 
entirely occluding the vagina, Avhich they incised. Immediately afterward 
the woman exhibited morning sickness and the usual signs of pregnancy, and 
M^as delivered in four months of a full-term child, the results of an impreg- 
nation occasioned by one of tlu^ unsuccessful attempts at entrance. Such 
instances are numerous in the older literature, and a mere citation of a few 
is considered sufficient here. Zacchias,'' Amand, Fabrieius Hildanus, Graaf, 
the discoverer of the follicles that bear his name, Borellus, Blegny, Blanchard,^ 
Diemcrbroeck,*^ Duddell, Mauriceau, a Reyes, Riolan,'' Harvey, the discoverer 
of the circulation of the blood,' Wolfius, Walther, Rongier,J Ruysch, For- 
estus, Ephemerides,*' and Schurig all mention cases of conception with intact 

a 476, 1807, i., 727. l> 538, 1889. c 130, March 9, 1861. 

d 389, L. ii., chap. 8, fol. 108. e 830, u. 42. f 213, cent. iii. 

g 303, L. i., c. 23. h 686, L. ii., c. .37. i 405, L. ii., 0. 11. 

J 462, T. xlix., 358. k 104, Dec. 1, ann. iii., ohs. 273. 


hymen, and in which there was no entrance of the penis. Tolberg '^- has 
an example of hymen integrum after the l^irth of a fetus five months oklj 
and there is recorded" a case of tubal pregnancy in which the hymen was 

Gilbert ^ giv^es an account of a case of pregnancy in an unmarried woman, 
who successfully resisted an attempt at criminal connection and yet became 
impregnated and gave birth to a perfectly formed female child. The hymen 
was not ruptured, and the impregnation could not have preceded the birth 
more than thirty-six weeks. Unfortiniately, this poor woman was infected 
with gonorrhea after the attempted assault. kSimmons of St. Louis'^ gives 
a curious peculiarity of conception, in which there was complete closure of 
the vagina, subsequent conception, and delivery at term. He made the 
patient's acquaintance from her application to him in regard to a malcondi- 
tion of her sexual apparatus, causing much domestic infelicity. 

Lawson*^ speaks of a woman of thirty-five, who had been married ten 
months, and whose husband could never effect an entrance ; yet she became 
pregnant and had a normal labor, despite the fact that, in addition to a tough 
and unruptiired hymen, she had an occluding vaginal cyst. Hickinbotham 
of Birmingham ^ reports the history of two cases of labor at term in females 
whose hymens were immensely thickened. H. Grey Edwards has seen a 
case of imperforate hymen which had to be torn through in labor ; yet one 
single act of copulation, even with this obstacle to entrance, sufficed to 
impregnate. Champion speaks of a woman who became pregnant although 
her hymen was intact. She had been in the habit of having coitus by the 
urethra, and all through her pregnancy continued this practice, 

Houghton^ speaks of a girl of twenty-five into whose vagina it was 
impossible to pass the tip of the first finger on account of the dense cicatricial 
membrane in the orifice, but who gave birth, with comparative ease, to a 
child at full term, the only interference necessary being a few slight incisions 
to permit the passage of the head. Tweedie^ saw an Irish girl of twenty- 
three, with an imperforate os uteri, who had menstruated only scantily since 
fourteen and not since her marriage. She became pregnant and went to 
term, and required some operative interference. He incised at the point of 
usual location of the os, and one of his incisions was followed by the flow of 
liquor amnii, and the head fell upon the artificial opening, the diameter of 
which proved to be one and a half or two inches ; the birth then progressed 
promptly, the child being born alive. 

Guerard ^ notes an instance in which the opening barely admitted a hair ; 
yet the patient reached the third month of pregnancy, at which time she 
induced abortion in a manner that could not be ascertained. Roe gives a 

a Collect. Acad, de Med., Paris, 1756, xii., 151. b 218, 1872, 298. 

c 703, 1847, 62-69. d 224, 1885, i., 1202. e 224, 1881, i., 1001. 

f 313, 1862. g 490, vol. xx., 202. ^261, 1895, No. 15. 


case of conception in an imiHrt'onitc utcrns,'' and Dnncan'' relates the history 
of a case of preuiuuK-v in an inirn|)tnrr(l hymen, characterized by an extra- 
ordinary ascent of the uterus. Among- many, the folhtwinti- inoch'rn observers 
have also rej)()rted instances of pregnancy with iiymen integrum : Braun,*' 
3 cases; Francis/' lIort<m,'^' Oakman,'' J>rill,^' 2 cases; Burgess,'' Haig/ 
Hay,' and Smith.'' 

instance--; in Avhich the presi'uce of an unrn])tnred hymen has complicated 
or retardi'd actual labor :r.'' (tuite connnon, and until the membrane is rup- 
tured l)y external means the labor is often etfectually obstructed. Among 
others reporting cases of this nature are Beale,' Carey,'" Davis, Emond," 
Fetherston, Leisenring," Maekinlay,'' Maitiuelli, Palmer,*! Rousseau, Ware, 
and Yale."" 

There arc many cases of stricture or complete occlusion of the vagina, con- 
genital or acquired from cicatricial contraction, obstructing delivery, and in 
some the impregnation seems more marvelous than cases in which the obstruc- 
tion is only a thin membranous hymen. Often the obstruction is so dense 
as to require a large bistoury to divide it, and even that is not always suffi- 
cient, and the Cesarean operation only can terminate the obstructed delivery ; 
we cannot surmise how conception could have been possible. Staples ^ records 
a case of pregnancy and parturition with congenital stricture of the vagina. 
Maisonneuve ^ mentions the successful practice of a Cesarean operation in a 
case of C07)genital occlusion of the vagina forming a complete obstruction to 
delivery. Verdile " records an instance of imperforate vagina in which the 
rectoN-aginal wall w^as divided and the delivery effected through the rectum 
and anus. Lombard ^ mentions an observation of complete occlusion of the 
vagina in a woman, the mother of 4 living children and pregnant for the 
fifth time. Thus, almost incredible to relate, it is possible for a woman to 
become a mother of a living child and yet preserve all the vaginal evidences 
of virginity. Cole^ describes a woman of twenty-tour who was delivered 
without the rupture of the hymen, and Meek "^ remarks on a similar case. 
\^e can readily see that, in a case like that of Verdile, in which rectal deliv- 
ery is effected, the hymen could be left intact and the product of conception 
be born alive. 

A natural sequence to the subject of impregnation without entrance is 
that of artificial impregnation. From being a matter of wonder and 

a 476, 1851, i., 564. b 769. 1875, iii., 91-93. 

c Wieu. Med. Wochen., 1876, xxvi., 289-316. ' d 43.5^ 1871, vi., 253. 

e 545, 1869, xxi., 314. f 476, 1851, i., 569. g 812, 1882. 

h476, 1876, ii., 237. i 180, 1870. J 547, 1873. k 592, 1858-9. 

1 476, 1859, ii., 98. m 525. 1855, i., 97. n 363, 1862, xxxv., 214. 

o 547, 1870-1, i., 395. P 476, 1840-1, i., 847. q 778, iv., 211. 

r 218, 1859-60, Ixi., 295. s Northwest Med. and Surg. Jour., St. Paul, 1870-71, i., 183. 

t 363, 1849, i., 451. u Morgagni, Xapoli, 1875, xvii., 747. ^ 368, 1831. 

^Western Lancet, San Francisco, 1873-4, ii., 705. ^ 17(5^ 1874-5, xii., 457. 


hearsay, it has been demonstrated as a practical and usefnl method in those 
cases in wliich, by reason of some unfortunate anatomic malformation on • 
either the male or the female side, the marriage is unfruitful. There are 
many cases constantly occurring in which the birth of an heir is a most 
desirable thing in a person's life. The historic instance of Queen Mar}^ of 
England, whose anxiety and efforts to bear a child were the subject of public 
comment and prayers, is but an example of a fact that is occurring every 
day, and doubtless some of these cases could be righted by the pursuance of 
some of the methods suggested. 

There have been rumors from the beginning of the century of women 
being impregnated in a bath, from contact with cloths containing semen, etc., 
and some authorities in medical jurisprudence have accepted the possibility 
of such an occurrence. It is not in the province of this work to speculate 
on what may be, but to give authoritative facts, from which the reader may 
draw his own deductions. Fertilization of plants has been thought to have 
been known in the oldest times, and there are some who believe that the 
library at Alexandria must have contained some information relative to it. 
The first authentic account that we Imve of artificial impregnation is that of 
Schwammerdam, who in 1680 attempted it without success by the fecunda- 
tion of the eggs of fish. Roesel, his scholar, made an attempt in 1690, l)ut 
also failed ; and to Jacol)i, in 1700, belongs the honor of success. In 1780, 
Abbe Spallanzani, following up the success of Jacobi, artificially impreg- 
nated a bitch, who brought forth in sixty-two days 3 puppies, all 
resembling the male. The illustrious John Hunter advised a man afilicted 
with h}^30spadias to impregnate his wife by vaginal injections of semen in 
water with an ordinary syringe, and, in spite of the simplicity of this 
method, the attempt was followed by a successful issue. Since this time, 
Nichohis of Xancy and Lesueur have practised the simple vaginal method ; 
while Gigon, d'Angouleme (14 cases), Girault (10 cases), Marion Sims, 
Thomas, Salmon, Pajot, Gallard, Courty, Roubaud, Dehaut, and others have 
used the more modern uterine method Avith success. 

A dog-breeder,* by syringing the uterus of a bitch, has succeeded in im- 
pregnating her. Those who are desirous of full information on this subject, as 
regards the modus operandi, etc., are referred to Girault ;'* this author reports 
in full several examples. One case was that of a woman, aged twenty-five, 
afflicted with blenorrhea, who, chagrined at not having issue, made repeated 
forcible injections of semen in water for two months, and finally succeeded 
in impregnating herself, and was delivered of a living child. Another case 
was that of a female, aged twenty-three, who had an extra long vaginal 
canal, probably accounting for the absence of pregnancy. She made injec- 
tions of semen, and was finally delivered of a child. He also reports the 
case of a distinguished musician who, by reason of hypospadias, had never 

a 806, 1884. b 100, 1868, 409. 




impregnated liis wife, and had resorted to injections of semen with a favor- 
able result. This latter case seems hardly warranted when we consider 
that men attlicted with hypospadias and epispadias have become fathers. 
Percy " gives the instance of a gentleman whom he had known for some 
time, whose urethra terminated a little below the frenum, as in other persons, 
but whose glans bulged qidte prominently beyond it, rendering urination in 
the forward direction impossible. Despite the fact that this man could not 
perform the ejaculatory function, he was the father of three children, two of 
them inheriting his penile formation. 

The fundamental condition of fecundity being the union of a spermato- 
zoid and an ovum, the oljject of artificial impregnation is to further this union 
by introducing semen directly to the fundus of the uterus. The operation is 
quite simple and as follows : The husband, having been found perfectly 
healthy, is directed to cohabit with his wife, using a condom. The semen 
ejaculated is sucked up by an intrauterine syringe (Fig. 1) which has been 

properly disinfected and kept 
warm. The os uteri is now 
exposed and wiped off with 
some cotton Avhich has been 
dipped in an antiseptic fluid ; 
the nozzle of the syringe is 
introduced to the fundus of 
the uterus, and some drops 
of the fluid slowly expressed 
into the uterus. The woman 
is then kept in bed on her 
back. This operation is best 
carried out immediately before or immediately after the menstrual epoch, and 
if not successful at the first attempt should be repeated for several months. 
At the present day artificial impregnation in pisciculture is extensively used 
with great success.'^ 
a 130, 1861. 

b xhe following extraordinary incident of accidental impregnation, quoted from the 
American Medical Weekly i by the Lancet,'- is given in brief, not because it bears any sem- 
blance of possibility, but as a curious example from the realms of imagination in medicine. 

L. G. Capers of Vicksburg, Miss., relates an incident during the late Civil War, as fol- 
lows : A matron and her two daughters, aged tifteen and seventeen years, filled with the 
enthusiasm of patriotism, stood ready to minister to the wonnds of their countrymen in their 

fine residence near the scene of the Ixattle of K , ]\Iay \2. 1863. between a iiortion of 

Grant's army and some Confederates. During the fray a gallant and noble young friend of 
the narrator staggered and fell to the earth ; at the same time a piercing cry was heard in the 
house near by. Examination of the wounded soldier .showed that a bullet had passed through 
the scrotum and carried away the left testicle. The same bullet had apparently penetrated the 
left side of the abdomen of the elder young lady, midway between the umbilicus and the 
anterior superior spinous process of the ilium, and had become lost in the abdomen. This 
1 131, Nov. 7, 1874. 2 476, 1875, i., 35. 

Fig. 1. — Apparatus for artificial impregnation. 


Interesting as are all the anomalies of conception, none are more so than 
those of unconscious impregnation ; and some well-authenticated cases . 
can be mentioned. Instances of violation in sleep, with subsequent preg- 
nancy as a result, have been reported in the last centnry by Valentini,"^-^ Gen- 
selius,'^ and Schnrig. Reports by modern anthorities seem to be quite scarce, 
though there are several cases on record of rape during anesthesia, followed 
by impregnation. Capuron ^^ relates a curious instance of a woman who was 
raped during lethargy, and who subsequently became pregnant, though her 
condition was not ascertained until the fourth month, the peculiar abdominal 
sensation exciting suspicion of the true nature of the case, which had pre- 
viously been thought impossible. 

There is a record of a case *^ of a young girl of great moral purity who 
became pregnant without the slightest knowledge of the source ; although, it 
might be remarked, such cases must be taken " cum grano salky Cases of 
conception without the slightest sexual desire or pleasure, either from fright, 
as in ra[)e, or naturally deficient constitution, have been recorded ; as well 
as conception during intoxication and in a hypnotic trance, which latter has 
recently assumed a much mooted legal aspect. As far back as 1680,'-^^ 
Duverney speaks of conception without the slightest sense of desire or pleasure 
on the part of the female. 

Conception with Deficient Organs. — Having spoken of conception 
with some obstructive interference, conception with some natural or acquired 
deficiency of the functional, organic, or genital apparatus must be considered. 
It is a well-known fact that women exhibiting rudimentary development of 
the uterus or vagina are still liable to become pregnant, and many such cases 
have been recorded ; but the most peculiar cases are those in which pregnancy 
has appeared after removal of some of the sexual apparatus. 

Pregnancy going to term with a successful delivery frequently follows 
the performance of ovariotomy with astonishing rapidity. Olier '^ cites an 

daugliter suffered an attack of peritonitis, but recovered in two months under the treatment 

Marvelous to rehite, just two hundred and seventy-eit^ht days after the reception of the 
minie-ball, she was delivered of a tine boy, weighing 8 pounds, to the surprise of herself and the 
mortitication of her parents and friends. The hymen was intact, and the young mother strenu- 
ously insisted on her virginity and innocence. About three weeks after this remarkable birth 
Dr. Capers was called to see the infont, and the grandmother insisted that there was something 
wrong with the child's genitals. Examination showed a rough, swollen, and sensitive scrotum, 
containing some hard substance. He operated, and extracted a smashed and battered minie- 
ball. The doctor, after some meditation, theorized in this manner : He concluded that this was 
the same ball that had carried away the testicle of his young friend, that had penetrated the 
ovary of the young lady, and, with some spermatozoa upon it, had impregnated her. With 
this conviction he approached the young man and told him the circumstances ; the soldier 
appeared skeptical at first, but consented to visit tlie young mother ; a friendship ensued 
which soon ripened into a happy marriage, and the pair had three children, none resembling, 
in the same degree as the first, the heroic pater famUias. 

a 104, 1715. b 254, 86. c 525, 1855. ^363, xlv., 1140. 


instance of ovariotomy with a j)re(;nancv of twins three montlis afterward, 
and acconchenient at term of two well-developed boys. Polaillon ^ speaks of 
a ])regnancy consecutive to ovariotomy, the accouchement being normal at 
terra. Crouch*^ reports a case of successful parturition in a patient who had 
previously undergone ovariotomy by a large incision. Parsons'^ mentions a 
case of twin pregnancy two years after ovariotomy attended with abnormal 
development of one of the ciiildrcn. ("utter'' speaks of a case in which a 
woman bore a cliild one year after the performance of ovariotomy, and 
IMppingskold ^ of two cases of pregnancy after ovariotomy in Avliich the 
stump as well as the remaining ovary were cauterized. Brown ^ relates a 
similar instance with successful delivery. Bixby,^ Harding,^ Walker 
(1878-9), and Mears* all report cases, and others are not at all rare. In 
the cases following shortly after operation, it has been suggested that they 
may be explained by the long retention of the ova in the uterus, deposited 
there ])rior to operation. In the i)resence of such facts one can but wonder 
if artificial fecundation of an ovum derived from another woman may ever 
be brought about in the uterus of a sterile woman ! 

Conception Soon After a Preceding Pregnancy. — Conception some- 
times follows birth (or abortion) with astonishing rapidity, and some women 
seem for a period of their lives either always pregnant or with infants at 
their breasts. This prolificitv is often alluded to, and is not confined to 
the lower classes, as often stated, but is common even among the nobility. 
Illustrative of this, we have examples in some of the reigning families in 
Europe to-day. A peculiar instance is given by SparkmanJ in which a 
woman conceived just forty hours after abortion. Rice '^ mentions the case 
of a woman who w^as confined witli her first child, a boy, on July 31, 1870, 
and was again delivered of another child on June 4, 1871. She had become 
pregnant twenty-eight days after delivery. He also mentions another case 
of a Mrs. C, who, at the age of twenty-three, gave l)irth to a child on 
September 13, 1880, and bore a second child on July 2, 1881. She must 
have become pregnant twenty-one days after the delivery of her first child. 

Superf etation has been known for many centuries ; the Romans had laws 
prescril)ing the laws of succession in such cases, and many medical writers have 
mentioned it. Hippocrates and Aristotle wrote of it, the former at some length. 
Pliny speaks of a slave who bore two infants, one resembling the master, the 
other a man with Avhom she had intercourse, and cites the case as one of super- 
fetation. Schenck ' relates instances, and Zacchias, Velchius, and Sinibaldus 
mention cases. Pare seemed to be well conversant with the possibility as 
well as the actuality of superfetation ; and Harvey '" reports that a certain 

a 168, 1879, vi., 243. b 550, xxxv., 71. c 476, 1866, i., 284. d 538, 1867-8. 

e 321, 1880. <" 548, 1854, ix., 566. g 476, 1881. 

h 476, 1880, i., 93. i 547, 1879. J 264, 1876. k 122, 1881, 206. 

1 L. iv., De Superfetation, 617. m 404^ fol. 479. 


maid, gotten with child by her master, in order to hide her knavery came to 
London in September, where she lay in by stealth, and being recovered, 
returned home. In December of the same year she was unexpectedly deliv- 
ered of another child, a product of superfetation, which proclaimed the crime 
that she had so cunningly concealed before. 

Marcellus Donatus, Goret, Schacher,"'" and INIauriceau * mention super- 
fetation. In the Academic des Sciences, at Paris, in 1702, there was men- 
tioned the case of a woman who was delivered of a boy ; in the placenta was 
discovered a sort of l)ladder which was found to contain a female fetus of 
the age of from four to five months ; and in 1729, before the same society, there 
was an instance in which two fetuses were born a day apart, one aged forty 
davs and the other at full term. From the description, it does not seem pos- 
sible that either of these were blighted twin pregnancies. Ruysch*^ gives an 
account of a surgeon's wife at Amsterdam, in 1686, who was delivered of a 
strong child which survived, and, six hours after, of a small embryo, the 
funis of which was full of hydatids and the placenki as large and thick as one 
of three months. Ruyscli accompanies his description with an illustrative 
figure. At Lyons, in 1782, Benoite Franquet was unexpectedly delivered 
of a child seven months old ; three weeks later she experienced symptoms 
indicative of the existence of another fetus, and after five months and six- 
teen days she was delivered of a remarkably strong and healthy child. 

Baudeloque'^ speaks of a case of superfetation observed by Desgranges 
in Lyons in 1780. After the birth of the first infant the lochia failed to 
flow, no milk appeared in the breasts, and the belly remained large. In 
about three weeks after the accouchement she had connection with her hus- 
band, and in a few days felt fetal movements. A second child was born at 
term, sixty-eight days after the first; and in 1782 both children were 
living. A woman of Aries'^ was delivered on November 11, 1796, of a 
child at term ; she had connection with her husband four days after ; the 
lochia stopped, and the milk did not flow after this intercourse. About one 
and a half months after this she felt quickening again, and naturally sup- 
posed that she had become impregnated by the first intercourse after confine- 
ment ; but five months after the first accouchement she was delivered of 
another child at term, the result of a superfetation. Milk in abundance 
made its appearance, and she was amply able to nourish both children from 
the breasts. Lachausse ^ speaks of a woman of thirty who bore one child 
on April 30, 1748, and another on September 16th in the same year. Her 
breasts were full enough to nourish both of the children. It might be 
remarked in comment on this case that, according to a French authority, 
the woman died in 1755, and on dissection was found to have had a double 

a 513, app. i., 65. b 698, Tome i., obs. 14. c Traite de I'Art des Accouchemens, ii. 
d 302, iv., 181. e De superfetation vera in utero simplici, Argentor., 1755. 


A peculiar instance of superfetation was reported by Laugmore'' in which 
there was an abortion of a fetus between the third and fourth months, appar- 
ently dead some time, and thirteen hours later a second fetus ; an ovum of 
about four weeks and of ])erfect formation was found adherent near the 
fundus. Tyler Smith'' mentions a lady pregnant for the first time who 
miscarried at five months and some time afterward discharged a small clot 
containing a perfectly fresh, and healthy ovum of about four weeks' forma- 
tion. There was no sign of a double uterus, and the patient menstruated 
regularly during pregnancy, being unwell three weeks before the abortion. 
Harley and Tanner ^ speak of a woman of thirty-eight who never had borne 
twins, and who aborted a fetus of four months' gestation ; serious hemorrhage 
accompanied the removal of the placenta, and on placing the hand in the uter- 
ine cavity an embryo of five or six weeks was found inclosed in a sac and 
floating in clear liquor amnii. The patient was the mother of nine children, 
the youngest of which was three years old. 

Young ^ speaks of a woman who three months previously had aborted a 
three months' fetus, but a tumor still remained in the abdomen, the auscultation 
of which gave evidence of a fetal heart-beat. Vaginal examination revealed 
a dilatation of the os uteri of at least one inch and a fetal head pressing out ; 
subsequently a living fetus of about six months of age was delivered. Se- 
vere hemorrhage complicated tlie case, but was controlled, and convales- 
cence speedily ensued. Huse ^ cites an instance of a mother bearing a boy 
on November 4, 1834, and a girl on August 3, 1835. At birth the boy 
looked premature, about seven months old, which being the case, the girl 
must have been either a superfetation or a seven months' child also. A"an 
Bibber of Baltimore says he met a young lady who was born five months 
after her sister, and who was still living. 

The most curious and convincing examples of superfetation are those in 
which children of different colors, either twins or near the same age, are 
born to the same woman, — similar to that exemplified in the case of the mare 
who was covered first by a stallion and a quarter of an hour later by an 
\/ ass, and gave )>irth at one parturition to a horse and a mule. *^ Parsons ^ 
speaks of a case at Charleston, S. C, in 1714, of a white woman who gave 
birth to twins, one a mulatto and the other white. She confessed that after 
her husband left her a negro servant came to her and forced her to comply 
with his wishes by threatening her life. Smellie mentions the case of a 
black woman who had twins, one child black and the other almost white. 
She confessed having had intercourse with a whife overseer immediately after 
her husl)and left her bed. Dewees*^ reports a similar case. Newlin of 
Nashville * speaks of a negress who bore tM'ins, one distinctly black with the 

a 778, iv., 135. b 476, April 12, 1856. c 778, Lond., 1863, iv., 165-169. 

d 124, 1868. e 2I8, 1856, liv. 294. f Acad, de Med., Aug., 1825. 

g 629, Oct., 1745. h 301, 1805, T. clxxiv. i Quoted in 300, Sept., 18OT. 


typical African features, while the other was a pretty mulatto exhibiting the 
distinct characters of the Caucasian race. Both the parents were perfect 
types of the black African negro. The mother, on being questioned, frankly 
acknowledged that shortlv after being with her husband she had lain a night 
with a white man. In this case each child had its own distinct cord and 

Archer'"* gives facts illustrating and observations showing : " that a 
white woman, by intercourse with a white man and negro, may conceive 
twins, one of which shall be white and the other a mulatto ; and that, vice 
versa, a black woman, by intercourse Avitli a negro and a white man, may 
conceive twins, one of which shall be a negro and the other a mulatto." 
Wight'' narrates that he was called to see a woman, the wife of an East 
Indian laborer on the Isle of Trinidad, who had been delivered of a fetus 
6 inches long, about four months old, and having a cord of about 18 inches 
in length. He removed the placenta, and in about half an hour the woman 
was delivered of a full-terra white female child. The first child was dark, 
like the mother and father, and the mother denied any possibility of its 
being a white man's child ; but this was only natural on her part, as East 
Indian husbands are so intensely jealous that they would even kill an un- 
faithful wife. Both the mother and the mysterious white baby are doing 
well. Bouillon" speaks of a negress in Guadeloupe who bore twins, one a 
negro and the other a mulatto. She had sexual congress with both a negro 
and a white man. 

Delmas,^ a surgeon of Rouen, tells of a woman of thirty-six who was 
delivered in the hospital of his city on February 26, 1H06, of two children, 
one black and the other a midatto. She had been pregnant eight months, 
and had had intercourse with a negro twice about her fourth month of j)reg- 
nancy, though living with the white man who first impregnated her. Two 
placentae were expelled some time after the twins, and showed a mem- 
branous junction. The children died shortly after birth. 

Pregnancy often takes place in a unicorn or bicorn uterus, leading to sim- 
ilar anomalous conditions. Galle, Hoffman, Massen, and Sanger give inter- 
esting accounts of this occurrence, and Ross® relates an instance of triple 
pregnancy in a double uterus. Cleveland ^ describes a discharge of an 
anomalous deciduous membrane during pregnancy which was probably from 
the nnimpregnated half of a double uterus. 

a 541, 1809-10. b 124, July 6, 1895, 14. c Bull, de la Society de Med., 1821. 

d 302, iv., 181. e Mediciu, Paris, 1879, v., No. 43. f 778, 1884, xxvi., 117. 


Extrauterine Pregnancy. — In the consideration of prenatal anomalies, 
the iir^t to be'd will be those of extrauterine pregnancy. This 
abnormalism has been known almost as long as there has been any real 
knowledge of obstetrics. In the writings of Albucasis,^^^ during the eleventh 
century, extrauterine pregnancy is discussed, and later the works of N. 
Polinns and Cordteus, abotit the sixteenth century, speak of it ; in the case 
of Cordseus the fetus was converted into a lithopedion and carried in the 
abdomen twenty-eight years. Horstius in the sixteenth century relates the 
history of a woman who conceived for the third time in INIarch, 1547, and 
in 1563 the remains of the fetus were still in the abdomen. 

Israel Spach, in an extensive gynecologic work })ublished in 1557, fig- 
ures a lithopedion drawn in situ in the case of a woman with her belly laid 
0})en. ile dedicated to this calcified fetus, which he regarded as a reversion, 
the followdug curious epigram, in allusion to the classical myth that after the 
flood the world was repopulated by the two stu'vivors, Deucalion and Pyrrha, 
wlio walked over the earth and cast stones behind them, which, on striking 
the ground, became people. Roughly translated from the Latin, this epigram 
read as follows : " Deucalion cast stones behind liim and thus fashioned our 
tender race from the hard marble. How comes it that nowadays, by a reversal 
of things, the tender body of a little babe has limbs nearer akin to stone ? " ** 
Many of the older writers mention this form of fetation as a curiosity, Ijut 
oifer no explanation as to its cause. Mauriceau °^'^ and deGraaf ^^* discuss in 
full extrauterine pregnancy, and Salmuth, Hannseus, and Bartholinus describe 
it. From the beginning of the eighteenth century this subject always 
demanded the attention and interest of medical observers. In more modern 
times, Campbell and Geoffroy-Saint-Hilaire, who named it " Grossesse Path- 
ologiqne," have carefully defined and classified the forms, and to-day every 
text-book on obstetrics gives a scientific discussion and classification of the 
diflferent forms of extrauterine pregnancy. 

The site of the conception is generally the Avail of the uterus, the Fallo- 
pian tube, or the ovary, altliough there are instances of pregnancy in the 
vagina, as for example wlicn there is scirrhus of the uterus ;'' and again, cases 

a 844, 274. l> 462, T. li. 5o. 



supposed to be only extrauterine have been instances simply of double uterus, 
with siugle or concurrent pregnancy. Ross ^ speaks of a woman of thirty- 
three who had been married fourteen years, had borne six children, and 
who on July 16, 1870, miscarried with twins of about five months' develop- 
ment. After a week she declared that she was still pregnant with another 
child, but as the physician had placed his hand in the uterine cavity after the 
abortion, he knew the fetus must be elsewhere or that no pregnancy existed. 
We can readily see how this condition might lead to a diagnosis of extra- 
uterine pregnancy, but as the patient insisted on a thorough examination, the 
doctor found by the stethoscope the presence of a beating fetal heart, and 
by vaginal examination a double uterus. On introducing a sound into the new 
ap(>rture he discovered that it opened into another cavity ; but as the woman 
was pregnant in this, he proceeded no further. On October 31st she was 
delivered of a female child of full srrowth. She had menstruated from tliis 
bipartite uterus three times during the period between the miscarriage of the 
twins and the birth of the child. Both the mother and child did well. 

In most cases there is rupture of the fetal sac into the abdominal cavity 
or the uterus, and the fetus is ejected into this location, from thence to be 
removed or carried therein many years ; but there are instances in which the 
conception has been found in situ, as depicted in Figure 2. A sturdy woman '^ 
of thirty was executed on January 16, 1735, for the murder of her child. It 
was ascertained that she had passed her catamenia about the first of the 
month, and thereafter had sexual intercourse with one of her fellow-prisoners. 
On dissection both Fallopian tubes were found distended, and the left ovary, 
which bore signs of conception, was twice as large as the right. Campbell -^^ 
quotes another such case in a woman of thirty-eight Avho for twenty years 
had practised her vocation as a Cyprian, and who unexpectedly conceived. 
At the third month of pregnancy a hard extrauterine tumor was found, 
which was gradually increasing in size and extending to the left side of the 
hypogastrium, the associate symptoms of pregnancy, sense of pressure, pain, 
tormina, and dysuria, being unusually severe. There was subsequently an 
attack of inflammatory fever, followed bv tumefaction of the abdomen, con- 
vulsions, and death on the ninth day. The fetus had been contained in the 
peritoneal coat of the ovary until the fourth month, when one of the feet 
passed through the cyst and caused the fatal result. Signs of acute peritonitis 
were seen postmortem, the abdominal cavity was full of blood, and the ovary 
much lacerated. 

The termination of extrauterine pregnancy varies ; in some cases the 
fetus is extracted l)y ojieration after rupture ; in others the fetus has been 
delivered alive by abdominal section ; it may be partially al)sorbed, or carried 
many years in the abdomen ; or it may ulcerate through, the confining walls, 
enter the bowels or bladder, and the remnants of the fetal body be discharged. 

a 476, 1871, ii., 189. b 527, vol. v., 277. 



The curious oases inciitioiicd hv older writers, and called abortion 
by the mouth, etc., arc doul)tlcss, in many instances, remnants of extra- 
uterine prciiiiancies or dermoid cysts. Maroldus ''''^" speaks in full of such 
cases; IJartholinus, Sahnutii,'' and a Reyes'' speak of women vomiting 
remnants of fetuses. In Germany/' in the seventeenth century, there lived 
a woman who on three different occasions is said to have vomited a fetus. The 
last miscarritiii'c in this manner was of eight months' growth and was accom- 

Fig. 2 -Pregnant Fallopian tnlic laid npi'ii. showing I lie fetus killcil l)y henioriiiage into its membranes, but 
williont tlie escape of tiie fetus from the tube (Tuttle and Cragin). 

panied by its j)lacenta. The older observers thought this woman must have 

had two orifices to her womb, one of which had some connection with the 

stomach, as they had records of the dissection of a female in whom was found 

a conformation similar to this. 

Discharge of the fetal bones or even the whole of an extrauterine fetus 

by the rectum is not unconnrion. There are two early cases mentioned '' in 

•1 TOG, (!<Mit. iii., No. 94. l> Campus Elys. Jncnnd., Qnsest. 41, 90. 

c 302, iv., 180. d629, 1748, 1015. 


which the bones of a fetus were discharged at stool, causing intense pain. 
Armstrong '^ describes an anomalous case of pregnancy in a syphilitic patient 
who discharged fetal bones by the rect um. Bubendorf '' reports the sponta- 
neous elimination of a fetal skeleton by the rectum after five years of reten- 
tion, with recovery of the patient. Butcher^ speaks of delivery through the 
rectum at the fourth month, with recovery. Depaul mentions a similar ex- 
pulsion after a pregnancy of about two months and a half. Jackson '' reports 
the dissection of an extrauterine sac which communicated freely with the 
large intestine. Peck ® has an example of spontaneous delivery of an extra- 
uterine fetus by the rectum, with recovery of the mother. Skippon, '^ in the 
early part of the last century, reports the discharge of the bones of a fetus 
through an '' imposthume" in the groin. Other cases of anal discharge of 
the product of extrauterine conception are recorded by Winthrop, Woodbury, 
Tuttle, Atkinson, Browne, Weinlechner, Gibson, Littre, Magruder, Gilland, 
and many others. De Brun du Bois-Noir § speaks of the expulsion of extra- 
uterine remains by the anus after seven years, and Heyerdahl'' after thirteen 
years. Benham ' mentions the discharge of a fetus by the rectum ; there 
was a stricture of the rectum associated with syphilitic patches, necessitating 
the performance of colotomy. 

Bartholinus '•"' and Kosseus ''•'-' speak of fetal bones being discharged 
from the urinary passages. Ebersbach, in the Ephemerides of 1717, 
describes a necropsy in which a human fetus was found contained in the 
bladder . In 1H78 White' reported an instance of the discharge of fetal 
remains through the bladder. 

Discharge of the Fetus through the Abdominal Walls. — Margaret 
Parry of Berkshire*^ in 1(368 voided the bones of a fetus through the flesh 
above the os pubis, and in 1684 she was alive and well, having had healthy 
children afterward. Brodie ^ reports the history of a case in a negress who ^^ 
voided a fetus from an abscess at the navel about the seventeenth month of 
conception. ^Modern instances of the discharge of the extrauterine letus 
from the walls of the abdomen are frequentlv re})orted. Algora ™ speaks of 
an al)dominal pregnancy in whicli there was spontaneous perforation of the 
anterior abdominal parietes, followed by death. Bouzal " cites an extraor- 
dinary case of ectopic gestation in which there was natural expulsion of the 
fetus through abdominal walls, with subsequent intestinal strangulation. An 
artificial anus was established and the mother recovered. Brodie, Dunglison, 
Erich, Rodbard, Fox, and Wilson are among others reporting the expulsion 
of remnants of ectopic pregnancies through the abdominal parietes. Camp- 
bell quotes the case of a Polish woman, aged thirty-five," the mother of nine 

a 490, 1835, xvi., 51. h 140, 1886, xxvi., 269. c Am. Med. Jour., St. Louis, 1886. 
d 218, 1865. e 218, 1870, Ixxxiii., 22. f 629, 1731. g 242. 1883. li 603, 1847. 
i 224, 1876. J 764 (1878), 1879, iii., 101. . k 629, 1700, 219. 1 Ibid. 

mCliuica, Zaragoza, 1878, ii., 221. n 497, 1884, 513. o 504, vol. xix.. No. 2. 



children, most of whom were stillborn, who conceived for the tenth time, the 
gestation hcinf; normal up to the lyinff-in period. She had ])ains followed 
by extraordinary effusion and some blood into the vagina. After various 
ju-otractcd comidaiiits the alxloininal tumor became ])ainfid and inflamed in 
the umbilical region. A breach in the walls soon formed, giving exit to 
purulent matter and all the bones of a fetus. During this process the patient 
receivetl no medical treatment, and frecpiently no assistance in dressing the 
opening. She recovered, but had an artificial anus all her life. Sarah 
McKinna** Avas married at sixteen and menstruated for the first time a 
month thereafter. Ten months after marriage she showed signs of i)reg- 
nancy and was delivered at full term of a living child ; the second child 
was born ten months after the first, and the second month after the second 
birth she again showed signs of pregnancy. At the close of nine months 
these symptoms, with the exception of the suppression of menses, subsided, 
and in this state she continued for six years. During the first four years she 
felt discomfort in the region of the umbilicus. About the seventh year 
she suffered tumefaction of the abdomen and thought she had conceived 
ag-ain. The abscess burst and an elbow of the fetus ])rotruded from the 
W(»und. A butcher enlarged the woinid and, fixing his finger under the jaw 
of the fetus, extracted the head. On looking into the abdomen he perceived 
a black object, whereupon he introduced his hand and extracted piecemeal 
an entire fetal skeleton and some decomposed animal-matter. The abdomen 
was bound up, and in six weeks the woman was enabled to superintend her 
domestic affairs ; excepting a ventral hernia she had no bad after-results. 
Kinuira,'' quoted by AVhitney, speaks of a case of extrauterine pregnancy in 
a Japanese woman of forty-one similar to the foregoing, in which an arm 
protruded through the abdominal wall above the umbilicus and the remains 
of a fetus were removed through the aperture. The accompanying illustra- 
tion (Fig. 3) shows the appearance of the arm in situ before extraction of 
the fetus and the location of the wound. 

Bodinier^' and Lusk '' report instances of the delivery of an extrauterine 
fetus by the vagina ; and Mathieson ^ relates the history of the delivery of a 
living ectopic child by the vagina, with recovery of the mother. Gordon ^ 
speaks of a curious case in a negress, six months pregnant, in which an extra- 
uterine fetus passed down from the posterior culdesac and occluded the 
uterus. It Avas removed through the vagina, and two days later labor-pains 
set in, and in two hours she was delivered of a uterine child. The placenta 
was left behind and drainage established through the vagina, and the woman 
made complete recovery. 
^ Combined Intrauterine and Extrauterine Gestation. — Many well- 
/authenticate<l cases of coml)ined pregnancy, in which one of the products of 

a 629, viii., .517. b 791^ i893. c 616, v., 79. 

d 125, xix., 242. e 224, 1884, i., 99. f 817, October, 1848. 



conception was intrauterine and the other of extrauterine gestation, have been 
recorded. Clark and Ramsloothani'* report instances of double conception, 
one fetus being; born alive in the ordinary manner and the other located 
extrauterine. Chasser^ speaks of a case in which there was concurrent 
pregnancy in both the uterus and the Fallopian tube. Smith *^ cites an 
instance of a woman of twenty-three who became pregnant in August, 1870. 
In the following December she passed fetal bones from the rectum, and a 
mouth later gave birth to an intrauterine fetus of six months' gro^\'th. 
McGee -^ mentions the case of a woman of twenty-eight who became pregnant 
in July, 1872, and on October 20th and 21st passed several fetal bones by the 
rectum, and about four months later expelled some from the uterus. From this 
time she rapidly recovered her strength and health, Devergie® quotes an 
instance of a woman of thirtv who had several children, but who died sud- 

Fig. 3.— A, protrusion of an arm in ectopic gestation ; B, after operation (Kimura). 

denly, and being pregnant was opened. In the right iliac fossa was found! 
a male child weighing 5 pounds and 5 ounces, 8 J inches long, and of 
about five months' growth. The uterus also contained a male fetus of about 
three months' gestation. Figure 4 shows combined intrauterine and extra- 
uterine gestation. Hodgen ^ speaks of a woman of twenty-seven, who was 
regular until November, 1872 ; early in January, 1873, she had an attack 
of pain with peritonitis, shortly after which what was apparently an extra- 
uterine pregnancy gradually diminished. On August 17, 1873, after a labor 
of eight hours, she gave l)irth to a healthy fetus. The hand in the uterus 
detected a tumor to the left, which was reduced to about one-fourth the 
former size. In April, 1874, the woman still suifered pain and tenderness 

a 5-18, 1856, 591. 
d 681, March, 1875. 

b 463, Aont.. 1812, 415. 
e Medecine Legale, i., 508. 

c 481. February. 1873. 
f 703, August, 1874. 



in tlie tuiiioi-. Hodgen believed this tt) have l)een originally a tubal preg- 
nancy, Avliieli burst, causing much licniorrhagc and the death of the fetus, 
together with a limited i)eritonitis. lieach'"' has seen a twin compound 
pregnancy in which after connection there was a miscarriage in six weeks, 
and four years after delivery of an extrauterine fetus through the abdominal 
walls. Cooke cites an example of intrauterine and extrauterine pregnancy 
]>rogressing sinudtaneously to full jx-riod of gestation, with resultant 
death. Rosset'' repcn'ts the case of a Avoman of twenty-seven, who menstru- 
ated last in Xovember, 1878, and on August 5, 1879, was delivered of a 
well-developed dead female child weighing seven pounds. The uterine 
contractions were feeble, and the attached placenta was removed only 
with diihculty ; there was considerable hemorrhage. The hemorrhage 

continued to occur at intervals of two 
weeks, and an extrauterine tumor re- 
mained. Two weeks later septicemia 
supervened and life was despaired of. 
On the 15th of October a portion of a 
fetus of five months' growth in an ad- 
vanced stage of decomposition protruded 
from the vulva. After the escape of this 
putrid mass her health returned, and in 
four months she was again robust and 
healthy. AVhinery *= speaks of a young 
woman who at the time of her second 
child-birth observed a tumor in the ab- 
domen on her right side and felt motion 
in it. In about a month she was seized 
w4th severe pain which continued a week 
and then ceased. Health soon improved, 
and the woman afterAvard gave birth to a third child ; subsequently she 
noticed that the tumor had enlarged since the first birth, and she had a recur- 
rence of pain and a slight hemorrhage every three weeks, and distinctly felt 
motion in the tumor. This continued for eighteen months, when, after a most 
violent attack of ])ain, all movement ceased, and, as she expressed it, she knew 
the moment the child died. The tumor lost its natural consistence and felt 
fial)V)y and dead. An incision was made through the linea all)a, and the 
knife came in contact witli a hard, gritty substance, three or four lines thick. 
The escape of several quarts of dark brown fluid followed the incision, and the 
operation had to be discontinued on account of the ensuing syncope. About 
six weeks afterward a bone presented at the orifice, which the woman extracted, 
and this was soon folhnved by a mass of bones, hair, and ])utrid matter. The 
cli.-5charge was small, and gradually grew less in quantity and oifensiveness, 
a 459, 18T1. b 133, April, 1878. c 124, 1846- 

Fig. 4. — Combined intrauterine and extrauterine 
gestation (Brit. Med. Jour., May 12, 189-1). 


soon ceasing altogether, and the wound closed. By December health was 
good and the menses had returned. 

Ahlfeld, Ambrosioni, Galabin, Packard, Thiernesse, Maxson, de Belami- 
zaran, Dibot, and Chabert are among others recording the phenomenon of 
coexisting extrauterine and intrauterine pregnancy. Argles* mentions 
simultaneous extrauterine fetation and superfotation. 

Sanger'' mentions a triple ectopic gestation, in which there was twin 
pregnancy in the wall of the uterus and a third ovum at the fimbriated end 
of the risfht tube. Careful examination showed this to be a case of intramural 
twin pregnancy at the point of entrance of the tube and the uterus, while at 
the abdominal end of the same tube there was another ovum, — the whole 
being an example of triple unilateral ectopic gestation. 

The instances of delivery of an extrauterine fetus, with viability of 
the child, from the abdomen of the mother would attract attention from 
their rarity alone, but when coupled with associations of additional interest 
thev surely deserve a place in a work of this nature. Osiander^'-^ speaks 
of an abdominal fetus being taken out alive, and there is a similar case on 
record in the early part of this century. *^ The London jNIedical and Physical 
Journal, in one of its early nunil)ers, contained an account of an abdominal 
fetus penetrating the walls of the ])ladder and being extracted from the walls 
of the hypogastrium ; but Sennertus gives a case which far eclipses this, both 
mother and fetus surviving. He says that in this case the woman, while 
pregnant, received a blow on the lower part of her body, in consequence of 
which a small tumor appeared shortly after the accident. It so happened in 
this case that the peritoneum was extremely dilatable, and the uterus, with 
the child inside, made its way into the peritoneal sac. In his presence 
an incision was made and the fetus taken out alive. Jessop*^ gives an ex- 
ample of extrauterine gestation in a woman of twenty-six, who had pre- 
viously had normal delivery. In this case an incision was made and a fetus 
of about eight months' growth was found lying loose in the abdominal cavity 
in the midst of the intestines. Both the mother and child were saved. This is 
a very rare result. Campbell, in his celel) rated monograph, in a total of ol 
operations had only seen recorded the accounts of two children saved, and one 
of these was too marvelous to believe. Lawson Tait reports a case in which 
he saved the child, but lost the mother on the fourth day. Parvin describes 
a case in which death occurred on the tliird day. BroAvne® quotes 
Parry as saying that there is one twin pregnancy in 23 extrauterine concep- 
tions. He gives 24 cases of twin conception, one of Avhich was uterine, the 
other extrauterine, and says that of 7 in the third month, with no opera- 
tion, the mother died in 5. Of 6 cases of from four and a half to seven 
months' duration, 2 lived, and in 1 case at the fifth month there was an 

a 476, 1871, ii., 394. 'J 261, 1893. c 559, 1809, 414. 

d778, xviii., 261; and 610, December, 1876. e 754, 1882, vi., 444-462. 


intrauterine fetus delivered which lived. Of 11 such cases at nine months, 
() mothers lived and () intrauterine fetuses lived. In 6 of these eases no 
operation was performed. In one case the mother died, but both the uterine 
and the extrauterine conceptions lived. In another the mother and intra- 
uterine fetus died, and the extrauterine fetus lived. Wilson'' gives an instance 
of a woman delivered of a healthy female child at eight months which lived. 
The alter-birth came away without assistance, but the woman still pre- 
senti'd every apj)earance of having another child within her, although ex- 
amination by the vagina revealed none. Wilson called Chatard in consulta- 
tion, and from the letal heart-sounds and other symptoms they decided that 
there was another pregnancy wholly extrauterine. They allowed the case to 
go twenty-three days, until pains similar to those of labor occurred, and 
then decided on celiotomy. The operation was almost bloodless, and a 
living child weighing eight pounds was extracted. Unfortunately, the 
mother succumbed after ninety hoin's, and in a month the intrauterine 
chihl died from inanition, but the child of extrauterine gestation thrived. 
Sales '' gives the case of a negress of twenty-two, who said that she had been 
" tricked by a negro," and had a large snake in the abdomen, and could dis- 
tinctly feel its movements. She stoutly denied any intercourse. It was 
decided to open the abdominal cyst ; the incision was followed by a gush 
of blood and a placenta came into view, M'hich was extracted with a living 
child. To the astonishment of the operators the uterus was distended, and 
it was decided to open it, when another living child was seen and extracted. 
The cyst and the uterus were cleansed of all clots and the wound closed. 
The mother died of septicemia, but the children both lived and were doing 
Avell six weeks after the operation. A curious case was seen in 1814 '^ of a 
woman who at her fifth gestation suifered abdominal uneasiness at the third 
month, and this became intoleral)le at the ninth month. The head of the 
fetus could be felt through the abdomen ; an incision was made through 
the parietes ; a fully developed female child was delivered, but, unfortunately, 
the mother died of septic infection. 

The British Medical Journal quotes : " Pinard (Bull, de I'Acad. de 
\ Med., August 6, 1895) records the following, which he describes as an ideal 
case. The jiatient Avas aged thirty-six, had had no illness, and had been 
regular from the age of fourteen till July, 1894. During August of that 
year she had nausea and vomiting ; on the 2 2d and 23d she lost a fluid, 
which was just pink. The symptoms continued during September, on the 
22d and 23d of which month there w^as a similar loss. In October she 
was kept in bed for tAvo days by abdominal pain, which reappeared in 
November, and Avas then associated with pain in micturition and defecation. 
From that time till Febniarv 2G, 1895, when she came under Pinard's 
care, she w'as attended by several doctors, each of whom adopted a different 

a 125, 1880, xiii., 821-836. b 593^ October, 1870. c 460, xv., 51. 


diagnosis and treatment. One of them, thinking she had a fibroid, made 
her take in all about an ounce of savin powder, which did not, however, pro- 
duce any ill effect. When admitted she looked ill and j)inched. The left 
thiffh and leg- were painful and edematous. The abdomen looked like that 
of the sixth month of pregnancy. The abdominal wall was tense, smooth, 
and without linese albicantes. Palpation revealed a cystic immobile tumor, 
extending 2 inches above the umbilicus and apparently fixed by deep 
adhesions. The fetal parts could only be made out with difficulty by deep 
palpation, ]>ut the heart-sounds were easily heard to the right of and l)elow 
the umbilicus. By the right side of this tumor one could feel a small one, 
the size of a Tangerine orange, which hardened and softened under examina- 
tion. When contracted the groove between it and the large tmiior became 
evident. Vaginal examination showed that the cervix, which was slightly 
deflected forward and to the right and softened, as in uterine gestation, was 
continuous with the smaller tumor. Cephalic ballottement was obtained in 
the large tumor. No sound was passed into the uterus for fear of setting up 
reflex action ; the diagnosis of extrauterine gestation at about six and a half 
months with a living child was established without requiring to be clinched 
by proving the uterus empty. The patient w^as kept absolutely at rest in 
bed and the edema of the left leg cured by position. On April 30th the 
fundus of the tumor was 35 cm. above the symphysis and the uterus 11| cm. ; 
the cervix was soft as that of a primipara at term. Operation, May 2d : 
Uterus found empty, cavity 14 J cm. long. Median incision in abdominal 
wall ; cyst walls exposed ; seen to be very slight and filled with enormous 
vessels, some greater than the little finger. On seizing the wall one of these 
vessels burst, and the hemorrhage was only rendered greater on attempting 
to secure it, so great was the friability of the walls. The cyst was therefore 
rapidly opened and the child extracted by the foot. Hemorrhage was re- 
strained first by pressure of the hands, then by pressure-forceps and ligatures. 
The walls of the cyst were sewn to the margins of the abdominal wound, the 
edge of the placenta being included in the suture. A wound w^as thus formed 
10 cm. in diameter, with the placenta for its base ; it was filled with iodo- 
form and salicylic gauze. The operation lasted an hour, and the child, a 
boy weighing 5J pounds, after a brief period of respiratory difficulties, was 
perfectly vigorous. There was at first a slight facial asymmetry and a 
depression on the left upper jaw caused by the point of the left shoulder, 
against which it had been pressed in the cyst ; these soon disappeared, and 
on the nineteenth day the boy weighed 12 pounds. The maternal wound was 
not dressed till May 13th, when it was washed wdth biniodid, 1 : 4000. 
The placenta came away piecemeal between May 25th and June 2d. The 
wound healed up, and the patient got up on the forty-third day, having 
suckled her infant from the first day after its birth." 




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Quite recently AVerder^' has investigated the question of the ultimate 
fate of ectopic children delivered alive. He has been able to obtain the 
nronl of 40 eases. Of these, IS died within a week afterbirth; 5 within a 
month ; 1 died at six months of bronchopneumonia ; 1 at seven months of 
diarrhea ; 2 at eleven months, 1 from croup ; 1 at eighteen months from cholera 
intantum — making a total of 26 deaths and leaving 14 children to be ac- 
counted for. Of these, 5 were reported as living and well after operation, ^\■itll 
no subsequent rej)ort ; 1 was strong and healthy after three Aveeks, but there 
has been no report since ; 1 was well at six months, then was lost sight of; 
1 was well at the last report ; 2 live and are well at one year ; 2 are living 
and well at two years ; 1 (Beisone's case) is \vell at seven years ; and 1 (Tait's 
case) is well at fourteen and one-half years. The list given on pages 60 and 
61 has been quoted by Hirst and Dorland.*^ It contains data relative to 17 
cases in which al)dominal section has been successfully performed for advanced 
ectopic gestation with living children. 

Long Retention of Extrauterine Pregnancy. — The time of the reten- 
tiou of an extrauterine gestation is sometimes remarkable, and it is no un- 
common occurrence for several pregnancies to successfully ensue during such 
retention. The Ephemerides contains examples of extrauterine pregnancy 
remaining in the abdomen forty-six years ;*^ Hannpeus'^^ mentioned an in- 
stance Temaining ten years, the mother being pregnant in the meantime ; 
Primperosius speaks of a similar instance ; de Blegny,'^ one of twenty-five 
years in the abdomen ; Birch, a case of eighteen years in the abdomen, the 
M'oman bearing in the meantime ; Bayle,^ one of twenty-six years, and the 
Ephemerides, another. In a woman of forty-six,^' the labor pains inter- 
vened without expulsion of the fetus. Impregnation ensued twice after- 
ward, each followed by the birth of a living child. The woman lived to 
be ninety-four, and was persuaded that the fetus was still in the abdomen, 
and directed a postmortem examination to be made after her decease, which 
was done, and a large cyst containing an ossified fetus was discovered in the 
left side of the cavity. In 1716'' a woman of Joignv when thirty years 
old, having l)cen married four years, became pregnant, and three months 
later felt movements and found milk in her breasts. At the ninth month 
she had labor-pains, but the fetus failed to present ; the pains ceased, but 
recurred in a month, still with a negative result. She fell into a most sickly 
condition and remained so for eighteen months, when the pains returned 
again, but soon ceased. Menstruation ceased and the milk in her breasts 
remained for thirty years. She died at sixty-one'of peripneumonia, and on 
postmortem examination a tumor was found occupying part of the hypogas- 
tric and uml)ilical regions. It Aveighed eight pounds and consisted of a male 

a 538, Nov. 24, 1894. b 843, 372. ' 104, cent, x., obs. 48. 

dProd. Act., Havn., 107. e 21.5, Auu. I., obs. U, .Jau.; obs. 8, Feb. 

f 629, London, xii. g 418, 1721, 422. ^ 302, iv.,233. 


fetus of full term with six teeth ; it had no odor and its sac contained no 
liquid. The bones seemed better developed than ordinarily ; the skin was 
thick, callous, and yellowish. The chorion, amnion, and placenta were ossi- 
fied and the cord dried up. Walther * mentions the case of an infant which 
remained almost jietrified in the belly of its mother ibr twenty-three years. 
No trace of the placenta, cord, or enveloping membrane could be found. 

Cordier ^ publishes a paper on ectopic gestation, with particular reference 
to tubal pregnancy, and mentions that when there is rupture between the 
broad ligaments hemorrhage is greatly limited by the resistance of the sur- 
rounding structures, death rarely resulting from the primary rupture in this 
location. Cordier gives an instance in which he successfully removed a full- 
grown child, the result of an ectopic gestation which had ru})tured intraliga- 
mentally and had been retained nearly two years. 

Lospichlerus ^ gives an account of a mother carrying twins, extrauterine, 
for six years. Mounsey of Riga, physician to the army of the Czarina, sent 
to the Royal Society in 1748 the bones of a fetus that had been extracted 
from one of the fallopian tubes after a lodgment of thirteen years. Starkey 
Middleton ** read the report of a case of a child which had been taken out of 
the abdomen, having lain there nearly sixteen years, during which time the 
mother had borne four children. It was argued at this time that boys were 
conceived on the right side and girls on the left, and in commenting on this 
Middleton remarks that in this case the woman had three boys and one girl 
after the right fallopian tube had lost its function. Chester*' cites the 
instance of a fetus being retained fifty-two years, the mother not dying 
until her eightieth year. Margaret Mathew^ carried a child weighing eight 
pounds in her abdomen for twenty-six years, and which after death was 
extracted. Aubrey ^' speaks of a woman aged seventy years unconsciously 
carrying an extrauterine fetus for many years, which was only discovered 
postmortem. She had ceased to menstruate at forty and had borne a child 
at twenty-seven. Watkins *^ speaks of a fetus being retained forty-three 
years ; James, others for twenty-five, thirty, forty-six, and fifty years ; 
Murfee,^ fifty-five years; Cunningham,' forty years; Johnson,'^ forty-four 
years ; Josephi,' fifteen years (in the urinary bladder) ; Craddock,™ twenty- 
two years, and da Costa Simoes," twenty-six years. 

Long Retention of Uterine Pregnancy. — Cases of long retained intra- 
uterine pregnancies are on record and deserve as much consideration as those 
that were extrauterine. Albosius speaks of a mother carrying a child in an 
ossified condition in the uterus for twenty-eight years.*' Cheselden speaks 

a Mem. de Berlin, 1774. b Annals of Gynaecol, and Pajdiatry, Ang., 1893. 

c Opera, 1737, iii., 89. d 629, 1748, 1018. e 550, vol. v., 104. f 629, 1700, 217. 
g 162, March, 1842. ^ 119,, viii., 106. i 774, 1886. J 810, 1855. 

kMed. Times and Gaz., London, 1872. 1 535, 1805. "1526, 1846. 

a 278, 1886. o Observatio Lithopsedii Seuonensis, 1682. 


of a case in whit'h a child was carried many years in the uterus, being con- 
verted intc, a clay-like substance, but preserving form and outline. Cald- 
well •' mentions the case of a woman wdio carried an ossified fetus in her uterus 
for sixty yeai's. Camerer^ describes the retention of a fetus in the uterus for 
fortv-six years ; Stcniicl,'= one for ten years, and Storer and Buzzell, for twenty- 
two months, llanuiinis, in KJSG, issued a paper on such a case under the 
title, "Mater, Infiiitis Mortiii Vivinii Sepulchrum," which may be found in 
French translation.'' 

lUichner *^ speaks of a fetus being retained in the uterus for six years^ 
and llorstius'*-'' relates a similar case, ychmidt's Jahrbiicher^ contain the 
I'ejtort of" a woman of forty-nine, who had borne two children. AVhile 
threshing corn she felt violent pain like that of labor, and after an illness 
sutfered a constant fetid discharge from the vagina for eleven years, fetal 
bones being discharged with occasional pain. This poor creature worked 
along for eleven years, at the end of which time she Avas forced to bed, and 
died of symptoms of purulent peritonitis. At the necropsy the uterus was 
found adherent to the anterior wall of the abdomen and containing rem- 
nants of a putrid ietus with its numerous bones. There is an instance re- 
conled = of the death of a fetus occurring near term, its retention and 
subsequent discharge being through a spontaneous opening in the abdominal 
wall one or two months after. 

Meigs ^ cites the case of a woman who dated her pregnancy from March, 
1848, and which proceeded normally for nine months, but no labor super- 
vened at this time and the menses reappeared. In March, 1849, she passed 
a few fetal bones by the rectum, and in May, 1855, she died. At the necropsy 
the uterus was found to contain the remains of a fully developed fetus, minus 
the portions discharged through a fistulous connection between the uterine 
cavity and the rectum. In this case there had been retention of a fully 
develo]ied fetus for nine years. Cox * describes the case of a w^oman who 
was pregnant seven months, and who was seized with convulsions ; the sup- 
posed labor-]iains passed off, and after death the fetus was fomid in the 
Momb, having lain there for five years. She had an early return of the 
menses, and these recurred regularly for four years. Dewees ^^^ quotes two 
cases, in one of Avhich the child was carried twenty months in the uterus ; 
in the other, the mother w^as still living two years and five months after 
fecundation. Another caseJ was in a woman of sixty, who had conceived at 
twenty-six, and whose fetus W'as found, partly ossified, in the uterus after 

There are many narratives of the long continuation of fetal move- 
ments, and during recent years, in the Southern States, there was quite a 

a 318, 1806, ii., 22-24. b ogo, 1774, v., 338. c Eyr, Christiania. 1827, ii., 134. 

d280, 1755, iii., 695. e Miscellan., 1728, 822. f 720, Nov. 9, 1848. 

g 124, v., 530. h 124, xxv., 541. i 271, 1867, ii., 385. J 318, ii., 22. 


prevalence of this kind of imposters. Many instances of the exhibition of 
fetal movements in the bellies of old negro women have been noticed by the 
lay jonrnals, but investigation proves them to have been nothing more than 
an exceptional control over the abdominal muscles, with the ability to 
simulate at will the supposed fetal jerks. One old woman went so far as 
to show the fetus dancing to the music of a banjo with rhythmical move- 
ments. Such imposters flourished best in the regions given to " voodooism." 
We can readily believe how easy the deception might be when we recall 
the exact simulation of the fetal movements in instances of pseudocyesis. 

The extraordinary diversity of reports concerning the duration of preg- 
nancy has made this a nmch mooted question. Many opinions relative to 
the longest and shortest period of pregnancy, associated with viability of the 
issue, have been expressed by authors on medical jurisprudence. There is 
perhaps no information more unsatisfactory or uncertain. Mistakes are so 
easily made in the date of the occurrence of pregnancy, or in the date of 
conception, that in the remarkable cases we can hardly accept the proposi- 
tions as worthy evidence unless associated with other and more convincing 
facts, such as the appearance and stage of development of the fetus, or cir- 
cumstances making conception impossible before or after the time mentioned, 
etc. It will be our endeavor to cite the more seemingly reliable instances 
of the anomalies of the time or duration of pregnancy reported in reputable 
periodicals or books. 

Short Pregnancies. — Hasenef^ speaks of the possibility of a living birth 
at four months ; Capurou relates the instance of Fortunio Liceti, who was said 
to have been born at the end of four and a half months and lived to complete 
his twenty-fourth year. In the case of the Marechal de Richelieu, the Parli- 
ament of Paris decreed that an infant of five months possessed that capability 
of living the ordinary period of existence, i, e., the " viabilite," which the law 
of France requires for the establishment of inheritance. In his seventh book 
Pliny gives examples of men who were born out of time. Jonston ^ gives 
instances of births at five, six, seven, and eight months. Bonnar *' quotes 5 
living births before the one hundred and fiftieth day ; 1 of one hundred and 
twenty-five days ; 1 of one hundred and twenty days ; 1 of one hundred and 
thirty-three days, surviving to twenty-one months ; and 1 of one hundred and 
thirty-five days' pregnancy surviving to eighty years. Maisonneuve '*^^ de- 
scribes a case in which abortion took place at four and a half months ; he found 
the fetus in its membranes two hours after delivery, and, on laying the mem- 
branes open, saw that it was living. He applied warmth, and partly succeeded 
in restoring it ; for a few minutes respiratory movements were performed regu- 
larly, but it died in six hours. Taylor '^^^ quotes Carter concerning the case 
of a fetus of five months which cried directly after it was born, and in the 
half hour it lived it tried frequently to breathe. He also quotes Davies, 

a Jena, 1705. b 447, 465. ^ 393, 133-4. 



mentioning an instance of a fetus of five months, which lived twelve hours, 
weighino- 2 jiounds, and measuring 12 inches, and which cried vigorously. 
Tlie pupilhirv nienibrane was entire, the testes had not descended, and the 
head was well covered with hair. Usher*^ speaks of a woman who in 1876 
was delivered of 2 male children on the one hundred and thirty-ninth day ; 
both lived for an hour; the first weighed 10 ounces 6 drams and meas- 
ured 9f inches; the other 10 (umces 7 drams, with the same length as 

the first. Routh"^ speaks of a Mrs. F , aged thirty-eight, who had borne 

9 children and had had 3 miscarriages, the last conception terminating 
as such. Her husband was away, and returned October 9, 1869. She did 
not again see lier husband until tiie ."id or Itli of Jantiarv. The date of 
quickening was not observed, and the child was born June 8, 1870. Dur- 
ing gestation she Avas much frightened by a rat. The child was weak, the 
testes tmdescended, and it lived but eighteen days, dying of symptoms of 
atrophy. The parents were poor, of excellent character, and although, 
according to the evidence, this pregnancy lasted bttt twenty-two weeks and 
t\\() days, there was absoltitely no reason to stispect infidelity. 

Ruttel speaks of a child of five months wlio lived twenty-four hours ; 
and he saw male twins l)orn at the sixth month Aveighing 3 pottnds each 
Avho Avere alive and healthy a year after. Barker ^ cites the case of a female 
child born on the one htindred and fifty-eighth day that Aveighed 1 pound 
and Avas 1 1 inches long. It had rudimentary nails, \'erv little hair on the 
head, its eyelids were closed, and the skin much shriveled ; it did not 
suckle ]iroperly, and did not Avalk tmtil nineteen months old. Three and a 
half years after, the child Avas healthy and thriving, but Aveighed only 29i 
pounds. At the time of birth it Avas Avrapped tip in a box and placed before 
the fire. Brouzet speaks of living births of from five to six months' preg- 
nancy, and Kopp'' speaks of a six months' child Avhich lived four days. The 
Ephemerides contains accounts of living jn-emature births. 

XcAvinton describes a pregnancy of fiA'e months terminating with the 
birth of twins, one of Avhom liA'cd tAventy minutes and the other fifteen. 
The first Avas 11 J^ inches long, and Aveighed 1 pottnd 3^ ounces, and the 
other Avas 11 inclies long, and Aveighed 1 pound. There is a recent instance 
of ])remature l)irth® following a pregnancy of between fiA'e and a half and 
six months, the infant Aveighing 955 grams. One month afterbirth, through 
the good offices of tlie wet-nurse and M. Villemin, Avho attended the child 
and Avho invented a "couveuse" for the occasion, it measured 38 cm. long. 

Moore ^ is accredited Avitli the trustwortliy rej)ort of the case of a Avoman 
Avho bore a child at the end of the fifth month Aveighing \h pounds and 
measuring 9 inches. It was first nourished by dropping liquid food into its 
mouth ; and at the age of fifteen months it was healtliy and Aveighed 18 

a 180, 1886, 366. ^ 778, xiii., 132. c 546, 1850, ii., 249, and 392. -1 444. iii., 129. 
e 674, 1895, Jan., p. 22. f 545, 1180; and quoted by 548, 1880, ii., 8. 


pounds. Eikam'^ saw a case of abortion at the fifth month in which the 
fetus was 6 iuclies in length and weighed about 8 ounces. The head was 
sufficiently developed and the cranial bones considerably advanced in ossifi- 
cation. He tied the cord and placed the fetus in warm water. It drew up 
its feet and arms and turned its head from one side to the other, opening its 
mouth and trying to breathe. It continued in this wise for an hour, the 
action of the lieart Ijcing visible ten minutes after the movements ceased. 
From its imperfectly developed genitals it was supposed to have been a 
female. Professor J. Miiller, to whom it was shown, said that it was not 
more than four months old, and this coincided with the mother's calculation. 

Villemin ^ before the Societe Obstetricale et Gynecologique reported the 
case of a two-year-old child, born in the sixth month of pregnancy. That 
the child had not had six months of intrauterine life he could vouch, the 
statement being borne out by the last menstrual period of the mother, the 
date of the first fetal movements, the child's weight, which was 30| ounces, 
and its appearance. Budin had had this infant under observation from the 
beginning and corroborated Villemin's statements. He had examined 
infants of six or seven months that had cried and lived a few days, and had 
found the alveolar cavities filled with epithelial cells, the lung sinking when 
placed in a vessel of water. Charpentier reported a case of premature birth 
in his practice, the child being not more than six and a half months and 
Aveighing 33J ounces. So sure was he that it would not live that he placed 
it in a basin Avhile he attended to the mother. After this had been 
done, the child being still alive, he wrapped it in cotton and was surprised 
next day to find it alive. It was then placed in a small, well-heated room 
and fed with a spoon on human milk ; on the twelfth day it could take the 
breast, since which time it thrived and grew. 

There is a case on record*^ of a child viable at six months and twenty 
days. The mother had a miscarriage at the beginning of 1877, after which 
menstruation became regular, appearing last from July 3 to 9, 1877. On 
January 28, 1878, she gave birth to a male infant, which was wrapped in 
wadding and kept at an artificial temperature. Being unable to suckle, it was 
fed first on diluted cow's milk. It was so small at birth that the father 
passed his ring over the foot almost to the knee. On the thirteenth day it 
weighed 1250 grams, and at the end of a week it was taking the breast. In 
December, 1879, it had 16 teeth, weighed 10 kilograms, walked with agility, 
could pronounce some words, and was especially intelligent. Capuron -** 
relates an instance of a child born after a pregnancy of six and a half 
months and in excellent health at two years, and another living at ten years 
of the same age at birth. Tait '^ speaks of a living female child, born on the 
one hundred and seventy-ninth day, with no nails on its fingers or toes, no 
hair, the extremities imperfectly developed, and the skin florid and thin. It 

a 558, B. v., H. 2. 'J 791, March, 1895. c 168, Dec, 1879. d 476, April 23, 1842. 


was too feeble to grasp its mother's nipple, and was fed for three weeks by 
milk from the breast through a quill. At forty days it weighed 3 pounds 
and measured 13 inches. Before the expiration of three months it died 
of measles. Dodd •"* describes a case in which the catamenia were on the 
24th of June, 1838, and continued a week ; the woman bore twins on 
January 11, 1839, one of which survived, the other dying a few minutes 
after birth. Slie was never inegidar, prompt to the hour, and this fact, 
coupled with the diminutive size of the children, seemed to verify the dura- 
tion of the pregnancy. Tn 1825, Baber of Buxur, India, spoke of a child 
born at six and a hali' months, who at the age of fifty days weighed 1 pound 
and 13 ounces and was 14 inches long. The longest circtimference of the 
head was 10 inches and the shortest 9.1 inches. The child suckled freely 
and readily. In Spaeth's clinic '' there was a viable infant at six and a half 
months weighing 900 grams. Spaeth says that he has known a child of six 
months to surpass in eventual development its brothers born at full term. 

In some cases there seems to be a peculiarity in women which manifests 
itself by regular premature births. La Motte, van Swieten, and Fordere 
mention females who always brought forth their conceptions at the seventh 

The inctibator seems destined to be the future means of preserving 
these premature births. Several successful cases have been noticed, and 
by means of an incubator Tarnier succeeded in raising infants which at the 
age of six months were above the average. A full description of the incu- 
bator may be found. *^ The modified Auvard incubator is easily made ; the 
accompanying illustrations (Figs. 5, 6, and 7) explain its mechanism. Several 
improved incubators have been described in recent years, but the Auvard ap- 
pears to be the most satisfactory. 

The question of retardation of labor, like that of premature birth, is 
open to much discussion, and authorities differ as to the limit of protraction 
with viability. Aulus Gellius '* says that, after a long conversation with the 
physicians and wise men, the Emperor Adrian decided in a case before 
him, that of a woman of chaste manners and irreproachable character, the 
child born eleven months after her husband's death was legitimate. Under 
the Roman law the Decemviri established that a woman may bear a viable 
child at the tenth month of pregnancy. Paulus Zacchias,^^^ physician to 
Pope Innocent X., declared that birth may be retarded to the tenth month, 
and sometimes to a longer period. A case was decided in the Supreme 
Court of Friesland, a province in the northern part of the Netherlands, 
October, 1634, in which a child born three hundred and thirty-three days 
after the death of the husband was pronounced legitimate. The Parliament 
of Paris was gallant enough to come to the rescue of a widow and save her 

a 656, 1841. b 118, May 16, 1882. c 536, 1883, i., 39. 

d L. iii., chap. 16. 



reputation by declaring that a child born after a fcjurteen months' gestation 
was legitimate. Bartholinus speaks of an unmarried woman of Leipzig who 
was delivered after a pregnancy of sixteen months. The civil code of 
France provides that three hundred days shall constitute the longest period 

Fig. 5.— Modified Auvard incubator; r, glass plate of the movable lid, 5; H, ventilating tube containing 
small rotary fan ; A' ventilating slide ; M, hot-water cans ; 0, slide closing hot-air chamber. 

of the legitimacy of an infant ; the Scottish law, three hundred days ; and the 
Prussian law, three hundred and one days. 

There are numerous cases recorded by the older writers. Amman ^-^ 
has one of twelve months' duration ; Enguin,'"* one of twelve months' ; 

i_^ Fig. 7.— Hot-water can for modified Auvard 
H incubator. 

Fig. 6. — Interior view of a modified Auvard incubator. 

Buchner, '^ a case of twelve months' ; Benedictus,^^*' one of fourteen months' ; 
de Blegny, "^ one of nineteen months' ; INIarteau,'^ Osiander, and others of 
forty-two and forty-four weeks' ; and Stark's Archives,® one of forty-five 

a 462, T. Ixi., 163. 
d 462, T, XXV. 

bMiscel., 1727, 170. 

c 215, Aiin. i., 23. 

e 162, L. ii., 3 St. n. 2. 


weeks', livino:. aiul also another ease of forty-four weeks'. An incredible 
case is recorded-' of an intant which lived after a three years' gestation. 
Instances of twelve months' duration are also recorded.^^'' ^'■^'' Jonston ■*'*^ 
quotes Paschal in rclatini>^ an instance of birth after pregnancy of twenty- 
three montlis ; .Vventiuni, one after two years ; and Mercurialis, a birth after 
a four years' gestation — which is, of course, beyond belief. 

Thornieau writes from Tours, 1580, of a case of gestation prolonged to 
the twenty-third month, and Santorini, at Venice, in 1721, describes a similar 
case, the child reaching adult life. El vert ^ records a case of late pregnancy, 
and Henschcl ^^"^ one of forty-six weeks, but the fetus was dead. Schneider^' 
cites an instance of three hundred and eiglit days' duration. Campbell says ^ 
that Simpson had eases of three luuidred and nineteen, three hundred and 
thirty-two, and three hundred and thirty-six days'; Meigs had one of four 
hundred and twenty. James Reid, in a table of 500 mature births, gives 
14 as being from three hundred and two to three hundred and fifteen days'. 

Not so long ago a jnry rendered a verdict of guilty of fornication and 
bastardy when it was alleged that the child was born three hundred and 
seventeen days after intercourse. Taylor relates a case of pregnancy in 
which the wife of a laborer went to America three hundred and twenty-two 
days before the birth. Jaife ^ describes an instance of the prolongation of 
pregnancy f(,)r three hundred and sixt}'-five days, in which the developments 
and measurements corresponded to the length of protraction. Bryan s speaks 
of a woman of twenty-five who became pregnant on Fel)ruarv 10, 1876, and 
on June 17th felt motion. On July 28th she was threatened with miscar- 
riage, and by his advice the ^voman weaned the child at the breast. She 
expected to be confined the middle of Xovember, 1876, but the expected 
event did not occur until April 26, 1877, nine months after the quickening 
and four hundred and forty days from the time of conception. The boy 
was active and weiglied nine pounds. The author cites Meigs' case, and also 
one of Atlee's, at three hundred and fifty-six days. 

Talcott,'' Superintendent of the State Homeopathic Asylum for the Insane, 
explained the pregnancy of an inmate who had been confined for four years 
in this institution as one of protracted labor. He said that many such 
cases have been reported, and that something less than two years before he 
had charge of a case in which the child was born. He made the report 
to the New York Senate Commission on Asylums for the Insane as one of 
three years' ])rotraction. Tidd ' speaks of a womau who was delivered of a 
male child at term, and again in ten months delivered of a well-developed 
male child weighing ~\ pounds ; he relates the history of another case, in 
Clifton, A\'. Va., of a woman expecting confinement on June 1st going over 

a 418, 1753, 206. b 462^ T. xxvii., 48. c 137^ B. iii., 257. 

d Annalen der Heilk., 1811, Oct., 87. e .5]o 188, viii.. 14.5, 149. f 261. 1890. 
g 703, 1877, n. s. xiv., 345. h 224, 1883, ii., 665. i 299, xi., 798. 


to September loth, the fetus being in the uterus over twelve months, and 
nine months after quiekening was felt. 

Two extraordinary eases are mentioned,-' one in a woman of thirtv-five, 
who expected to be contined April 24, 1883. In ]\Iay she had a few labor- 
pains that passed away, and during the next six months she remained about 
as large as usual, and was several times thought to be in the early stages of 
labor. In September the os dilated until the first and second fingers could 
be passed directly to the head. This condition lasted about a month, but 
passed away. At times during the last nine months of pregnancy she was 
almost unable to endure the movements of the child. Finally, on the morn- 
ing of November 6th, after a pregnancy of four hundred and seventy-six 
days, she was delivered of a male child weighing 13 pounds. Both the 
mother and child did well despite the use of chloroform and forceps. The 
other case was one lasting sixteen months and twenty days. 

In a rather loose argument, Carey reckons a case t)f three hundred and 
fiftv days. Menzie '' gives an instance in a woman aged twenty-eight, the 
mother of one child, in whom a gestation was prolonged to the seventeenth 
month. The pregnancy was complicated by carcinoma of the uterus. Bal- 
lard^ describes the case of a girl of sixteen years and six months, Avhose 
pregnancy, the result of a single intercourse, lasted three hundred and sixty 
davs. Her labor was short and easy for a primijxira, and the child was of 
the average size. Mackenzie'^ cites the instance of a woman aged thirty- 
two, a primipara, who had been married ten years and who always had been 
regular in menstruation. The menses ceased on April 28, 1888, and she felt 
the cliild for the first time in September. She had false pains in January, 
1889, and labor did not l)egin until March 8th, lasting sixty-six hours. If all 
these statements are correct, the probable duration of this pregnancy was 
eleven months and ten days. 

Lundie'' relates an example of protracted gestation of eleven months, in 
which an anencephalous fetus was born ; and Martin of Birmingham de- 
scribes a similar case of ten and a half months' duration. Raux-Tripier ^ 
has seen protraction to the thirteenth month. Enguin^ reports an observa- 
tion of an accouchement of twins after a pregnancy that had been prolonged 
for eleven months. Resnikoif'^ mentions a pregnancy of eleven months^ 
duration in an anemic secundipara. The case had been under his observa- 
tion from the beginning of pregnancy ; the patient would not submit to 
artificial termination at term, which he advised. After a painful labor of 
twenty-four hours a macerated and decomposed child was born, together 
with a closely-adherent placenta. Tarnier^ reports an instance of partus 
serotinus in Mhich the product of conception was carried in the uterus forty 

a 790, Dec. 27, 1884. b 381, 1853-4. <= 224, 1884, i., 56. 

'^536, 1889, ii., 522. e 759, April, 1895. f 233, 1847. 

g 460, 1784, 163. h 261, No. 24, 1894. i Jour, cles Sages-Femmes, May 1, 1894. 


days after term. The fetus was macerated but not putrid, and the placenta 
had underodiie fattv deo-eueration. At a recent meetinsr of the Chicaao 
Gynecoloo^ical Society, Dr. F. A. Stahl reported the case of a German-Bohe- 
mian wDiiian ill which the fifth pregnancy terminated three hundred and two 
days after the hist menstruation. Twenty days before there had occurred 
pains similar to those of labor, but they gradually ceased. The sacral prom- 
ontor}^ was exaggerated, and the anteroposterior pelvic diameter of the inlet 
in consequence diminished. The fetus was large and occupied the first posi- 
tion. Version Avas with difficulty effected and the passage of the after- 
coming head through the superior strait required expression and traction, 
•hiring which the ciiild died. The mother euffered a deep laceration of the 
perineum involving an inch of the wall of the rectum. 

Among others reporting instances of jJi'otracted pregnancy are Collins," 
eleven months; Desbrest, "^ eighteen months; Henderson, •= fifteen months; 
Jefferies,** three hundred and fifty-eight days, and De la Vergne® gives the 
history of a woman who carried an infant in her womb for twenty-nine 
months ; tliis case may possibly belong under the head of fetus long retained 
in the uterus. 

Unconscious Pregnancy. — There are numerous instances of women who 
have had experience in pregnancy unconsciously going almost to the moment 
of delivery, yet experiencing none of the usual accompanying symptoms of 
this condition. CrowelH speaks of a woman of good social position who liad 
been married seven years, and who had made extensive preparations for a 
long journey, when she was seized with a " bilious colic," and, to her dismay 
and surprise, a child was born before the arrival of the doctor summoned on 
account of her sudden colic and her inal)ility to retain her water. A peculiar 
feature of this case was the fact that mental disturbance set in immediatelv 
afterward, and the mother became morbid and had to be removed to an asy- 
lum, but recovered in a few months. Tanner ^ saw a woman of forty-two who 
had been suffering with alidominal pains. She had been married three vears 
and had never been pregnant. Her catamenia were very scant, but this Avas 
attributed to her change of life. She had conceived, had gone to the full 
term of gestation, and was in labor ten hours without any suspicion of preg- 
nancy. She was successfully delivered of a girl, which occasioned much 
rejoicing in the household. 

Taskerof Kendall's ]\Iills, Me., reports the case of a young married woman 
calling him for l)ilious colic. He found the stomacli slightly distended and 
questioned her about the possibility of pregnancy. Both she and her hus- 
band informed him that such could not be the case, as her courses had lieen 
regular and her waist not enlarged, as she had worn a certain corset all 
the time. There were no signs of quickening, no change in the breasts, and, 

a 318, 1826, xxv., 245. b 453, 1769. c 125^ 1879^ xii., 393. 

d Trans. M. Soc. Peniia., Phila., 1879. e 458, 1761. f 218, 1878. g 778, 1864. 


in fact, none of the nsual signs of pregnancy present. He gave her an opiate, 
and to lier surprise, in about six hours she was the mother of a boy weio-h- 
ing five pounds. Both the mother and child made a good recoverv. Duke '■" 
-cites the instance of a woman who supposed that she was not pregnant up to 
the night of her miscarriage. She had menstruated and was suckling a child 
sixteen months old. During the night she was attacked wdth pains resem- 
bling those of labor and a fetus slipped into the vagina without any hemor- 
rhage ; the placenta came away directly afterward. In this peculiar case the 
woman was menstruating regularly, suckling a child, and at the same time 
was unconsciously pregnant. 

Isham ^ speaks of a case of unconscious pregnancy in which (wtremelv 
small twins were delivered at the eighth month. Fox '-' cites an instance 
of a woman who had borne eight children, and yet unconscious of 
pregnancy. Merriman ^ speaks of a woman forty years of age who had not 
^ borne a child for nine years, but who suddenly gave birth to a stout, healthv 
boy without being cognizant of pregnancy. Dayral^ tells of a woman who 
carried a child all through pregnancy, unconscious of her condition, and mIio 
was greatly surprised at its birth. Among the French observers speak- 
ing of pregnancy remaining unrecognized by the mother until the period 
of accouchement, Lozes and Rhades record peculiar cases ; and Mouron- 
vals relates an instance in which a woman who had borne three children 
completely ignored the presence of pregnancy until the pains of labor were 
felt. Fleishman ^ and Miinzenthaler also record examples of unconscious 

Pseudocyesis. — On the other hand, instances of pregnancy with 
imaginary symptoms and preparations for birth are sometimes noticed, and 
many cases are on record. In fact, nearly every text-book on obstetrics 
gives some space to the subject of pseudocyesis. Suppression of the menses, 
enlargement of the abdomen, engorgement of the breasts, together Avith the 
symptoms produced by the imagination, such as nausea, spasmodic contraction 
of the abdomen, etc., are for the most part the origin of the cases of pseudo- 
cyesis. Of course, many of the cases are not examples of true pseudocyesis, 
with its interesting phenomena, but instances of malingering for mercenary 
or other purposes, and some are calculated to deceive the most expert 
obstetricians by their tricks. Weir Mitchell' delineates an interesting 
case of pseudocyesis as follows : "A woman, young, or else, it may be, at or 
past the climacteric, eagerly desires a child or is horribly afraid of becoming 
pregnant. The menses become slight in amount, irregular, and at last 
cease or not. Meanwhile the abdomen and breasts enlarge, owing to a rapid 
taking on of fat, and this is far less visible elsewhere. There comes Avith 
this excess of fat the most profound conviction of the fact of pregnancy. By 

a 312, 1846. b 104, 1874. c 649, 1888. d 2I8, 1828. e 146, 1865. 

f 146, 1865. g 454, 1825, xxiii., 281. h 834, 1839. 1533,1895,393. 


and l)v the cliild is felt, the physician takes it for granted, and this goes on 
until the great diagnostician, Time, corrects the delusion. Then the fat 
disappears with remarkable speed, and the reign of this singular simulation 
is at an end." In the same article, Dr. ^Mitchell cites the two following 
cases under his personal observation : '' I was consulted by a lady in regard 
to a woman of thirty years of age, a nurse in whom she was interested. 
Tiiis person had been married some three years to a very old man possessed 
of a considerable estate. He died, leaving his wdfe her legal share and the 
rest to distant cousins, unless the wife had a child. For two months before 
he died the woman, who was very anemic, ceased to menstruate. She became 
sure that she was pregnant, ami thereu[)on took on flesh at a rate and in a 
wav which seemed to justify her lielief. Her breasts and abdomen were the 
chief seats of this overgrowth. The menses did not return, her pallor in- 
creased ; the child was felt, and every preparation made for delivery. At 
the eighth month a physician made an examination and assured her of the 
absence of pregnancy. A second medical opinion confirmed the first, and 
the tenth month found her of immense size and still positive as to her con- 
dition. At the twelfth month her menstrual flow returned, and she became 
sure it was the early sign of labor. AVhen it passed over she became con- 
vinced of her error, and at once dropped weight at the rate of half a pound 
a day despite every effort to limit the rate of this remarkable loss. At the 
end of twv! months she had parted with fifty pounds and was, on the whole, 
less anemic. At this stage I was consulted by letter, as the woman had be- 
come exceedingly hysteric. This briefly stated case, which occurred many 
years ago, is a fair illustration of my thesis. 

'• Another instance I saw when in general practice. A lady who had 
several children and suffered much in her pregnancies passed five years 
without becoming impregnated. Then she missed a period, and had, as 
usual, vomiting. She made some wild efforts to end her supposed pregnancy, 
and failing, acquiesced in her fate. The menses returned at the ninth month 
and were presumed to mean labor. Meanwhile she vomited, up to the eighth 
month, and ate little. Nevertheless, she took on fat so as to make the abdo- 
men and breasts immense and to excite unusual attention, Xo physician 
examined her until the supposed labor began, when, of course, the truth 
came out. She was pleased not to have another child, and in her case, as in 
all the others known to me, the fit lessened as soon as the mind was satisfied 
as to the non-existence of pregnancy. As I now recall the facts, this 
woman was not more than two months in getting rid of the excess of adipose 
tissue. Dr. Hirst tells me he has met with cases of women taking on fat 
with cessation of the menses, and in which there was also a steady l)elief in 
the existence of pregnancy. He has not so followed up these cases as to 
know if in them the fat fell away with speed when once the patient was as- 
sured that no child existed within her." 

Plate 2. 

Conditions simulating pregnancy (pseudocyesis) (Hirst) : 1. Pendulous belly of rachitis. 
2. Normal distention in a primipara at term. 3. Normal distention, seventh month. 4. Pen- 
dulous belly of rachitis (Cesarean section). 5. Twins. 6. Pendulous belly of rachitis ; lat 
and tympany. 7. Hydramnios. 


Hirst,^ in an article on the difficulties in the diagnosis of pregnancy, gives 
several excellent photographs showing the close resemblance between several 
pathologic conditions and the normal distention of the abdomen in preg- 
nancy (Plate 2). A woman'' who had several children fell sick with 
a chest-affection, followed by an edema. For fifteen months she was con- 
fined to her l)ed, and had never had connection with her husband during that 
time. Her menses ceased ; her niamniie became eno-ortjed and discharged 
a serous lactescent fluid ; her belly enlarged, and both she and her phy- 
sician felt fetal movements in her abdomen. As in her previous pregnancies, 
she suffered nausea. Naturally, a suspicion as to her virtue came into her 
husband's mind, but when he considered that she had never left her bed for 
fifteen months he thought the pregnancy impossible. Still the wife insisted 
that she was pregnant and was confirmed in the belief by a midwife. The 
belly continued to increase, and about eleven months after the cessation of 
the menses she had the pains of labor. Three doctors and an accoucheur 
were present, and w^hen they claimed that the fetal head presented the hus- 
l)and gave up in despair ; Init the supposed fetus was born shortly after, and 
proved to be only a mass of hydatids, with 'not the sign of a true pregnancy, 
(lirard of Lyons'' speaks of a female who had been pregnant several times, 
but again experienced the signs of pregnancy. Her mammse were engorged 
with a lactescent fluid, and she felt belly-movements like those of a 
child ; but during all this time she had regular menstruation. Her abdo- 
men progressively increased in size, and between the tenth and eleventh 
months she suffered what she thought to be labor-pains. These false pains 
ceased ujion taking a ])ath, and with the disappearance of the other signs 
was dissipated the fallacious idea of pregnancy. 

There is mentioned '' an instance of medicolegal interest of a young girl 
who showed all the signs of pregnancy and confessed to her parents that she 
had had commerce wdth a man. The parents immediately prosecuted the 
seducer by strenuous legal methods, but when her ninth month came, and after 
the use of six baths, all the signs of pregnancy vanished. Harvey cites sev- 
eral instances of pseudocyesis, and says we must not rashly determine of the 
tiie inordinate birth before the seventh or after the eleventh month. In 1046 
a woman, after having laughed heartily at the jests of an ill-bred, covetous 
clown, was seized w ith various movements and motions in her belly like those 
of a child, and these continued for over a month, Avhen the courses appeared 
again and the movements ceased. The woman was certain that she w^as 

The most noteworthy historic case of pseudocyesis is that of Queen Mary 
of England, or " Bloody jNIarv," as she was called. To insure the succession 
of a Catholic heir, she was most desirous of having a son by her consort, 
Philip, and she constantly prayed and wished for pregnancy. Finally her 

a 792, May, 1895. b 302, iv., 235. c ibid. d Ibid. 


jiK'Hses stopped ; the breasts he<>:an to enlarirf and became discolored around 
the nij)ples. She had niornin<i-sickness ot" a violent nature and her abdomen 
enlari>;ed. On consultation with the ladies of her court, her opinion of preg- 
nancy was strongly confirmed. Her favorite amusement then was to make 
bal)y-clothes and count on her fingers the months of pregnancy. AVhen the 
end of the ninth month a]iproached, the ])eo])le were awakened one night by 
the joyous j)cals of the brlls ot" I^ondon aiuiouncing the new heir. An am- 
bassador had been sent to tell the Pope that Mary could feel the new life 
Avithin her, and the people rushed to St. Paul's Cathedral to listen to the 
venerable .Vrchbishop of Canterbury describe the baby-prince and give 
thanks for his deliverance. The spurious labor pains passed away, and 
after being assured that no real pregnancy existed in her case, ]Mary went 
into violent hysterics, and Philij), disgusted with the whole affair, deserted 
her ; thi'u counuenccd the persecution of the Protestants, which blighted the 

Putnam =' cites the case of a healthy brunet, aged forty, the mother of three 
children. She had abrupt vertical abdominal movements, so strong as to 
cause her to plimge and sway from side to side. Her breasts were enlarged, 
the areola dark, and the uterus contained an elastic timior, heavy and roll- 
ing- under the hand. Her abdomen progressively enlarged to the regular 
size of matured gestation ; l)ut the extrauterine pregnancy, which was sup- 
posed to have existed, was not seen at the autopsy, nothing more than an 
enlarged liver being found. The movement was due to spasmodic move- 
ments of the abdominal muscles, the causes being unknown. Madden '' gives 
the history of a primipara of twenty-eight, married one year, to whom he 
was called. On entering the room he was greeted Ijy the midwife, who said 
she expected the child about 8 p. m. The woman was lying in the usual 
obstetric position, on the left side, groaning, crying loudly, and pulling hard 
at a strap fastened to the bed-post. She had a partial cessation of menses, 
and had complained of tumultuous movements of the child and overfiow of 
milk from the breasts. Examination showed the cervix low down, the os 
small and circular, ;uid no signs of ])regnancv in the uterus. The abdomen 
was distended with tymjiauites and the rectum much dilated with acctimulated 
feces. Dr. ]Madden left her, telling her that she was not pregnant, and when 
she reappeared at his office in a few davs, he reassured her of the nonexist- 
ence of pregnancy ; she became very indignant, triumphantly squeezed lac- 
tescent fluid from her breasts, and, insisting that she could feel fetal move- 
ments, left to seek a more sympathetic accoucheui\ Underhill,^ in the words 
of Hamilton, describes a wonuin as "having ac(|uired the most accurate 
description of the breeding synij)toms, and with wonderful facility imagined 
that she had felt every one of them." He found the woman on a l)ed com- 
plaining of ii'rcat labor-])ains, biting a handkerchief, and jndling on a cloth 

a 218, 1870. 1*310, 1872, liii., 255. c 318, 1873-4, xix., ii., 844. 


attached to her bed. The finger on the abdomen or vulva elicited symptoms 
of great sensitiveness. He told her she was not pregnant, and the next day 
she was sitting up, though the discharge continued, but the simulated throes 
of labor, which she had so graphically pictured, had ceased. 

Haultaiu'"* gives three examples of pseudocyesis, the first with no apparent 
cause, the second due to carcinoma of the uterus, while in the third there was 
a small fibroid in the anterior wall of the uterus. Some cases are of purely 
nervous origin, associated with a purely muscular distention of the abdomen. 
Clay reported a case due to ascites. Cases of pseudocyesis in women con- 
victed of nnirdcr are not uncommon, though most of them are imposters 
hoping for an extra lease of life. 

Croon '' speaks of a child seven years old on whom he performed ovari- 
otomy for a round-celled sarcoma. She had been well up to May, but since 
then she had several times been raped by a boy, in consequence of which she 
had constant uterine hemorrhage. Shortly after the first coitus her abdomen 
began to enlarge, the breasts to develop, and the areolae to darken. In seven 
months the abdomen }>resented the signs of pregnancy, but the cervix was soft 
and patulous ; the sound entered three inches and was followed by some hemor- 
rhage. The child was well developed, the mons was covered with hair, and 
all the associate symptoms tended to increase the deception. 

Sympathetic Male Nausea of Pregnancy. — Associated with preg- 
nancy there are often present morning-nausea and vomiting as prominent 
and reliable symptoms. Vomiting is often so excessive as to be pro- 
vocative of most serious issue and even warranting the induction of 
abortion. This fact is well known and has been thoroughly discussed, 
but with it is associated an interesting point, the occasional association 
of the same symptoms sympathetically in the husband. The belief has 
long been a superstition in parts of Great Britain, descending to America, 
and even exists at the present day. Sir Francis Bacon has written on this 
subject, the substance of his argument being that certain loving husl)ands 
so sympathize with their pregnant wives that they suffer morning-sickness 
in their own person. No less an authority than S. AVeir Mitchell called 
attention to the interesting subject of sympathetic vomiting in the husband 
in his lectures on nervous maladies some years ago. He also quotes the 
following case associated with pseudocyesis : — 

" A woman liad given birth to two female children. Some years passed, 
and her desire for a l)oy was ungratified. Then she missed her flow once, 
and had thrice after this, as always took place with her when pregnant, a very 
small but regular loss. At the second month morning-vomiting came on as 
usual with her. ISIeanwhile she became very fat, and as the growth was 
largely, in fact excessively, abdominal, she became easily sure of her condi- 
tion. She was not my patient, but her husband consulted me as to his own 

a 124, April, 1891. b 318, Feb., 1893. 


morning-sickness, which came on with the first occurrence of this sign in his 
wife, as had been the case twice before in her former pregnancies. I advised 
him to leave home, and this ])roved effectual. I learned later that the 
woman continued to gain flesh and l)e sick every morning until the seventh 
month. Then menstruation returned, an examination was made, and when 
sure that there was no possibility of her being pregnant she began to lose 
flesli, and within a few months regained her usual size." 

Hamill^ reports an instance of morning-sickness in a husband two weeks 
after the appearance of menstruation in the wife for the last time. He had 
daily attacks, and it was not until the failure of the next menses that the 
woman had any other sign of pregnancy than her husband's nausea. His 
nausea continued for two months, and was the same as that which he had 
suffered during his wife's former pregnancies, although not until both he and 
his wife became aware of the existence of pregnancy. The Lancet'' describes 
a case in which the husband's nausea and vomiting, as well as that of the wife, 
began and ended simultaneously. Judkins^ cites an instance of a man who 
was sick in the morning while his wife was carrying a child. This occurred 
during every pregnancy, and the man related that his own father was simi- 
larly affected while his mother was in the early months of pregnancy with 
him, showing an hereditary predisposition. 

The perverted appetites and peculiar longings of pregnant women 
furnish curious matter for discussion. From the earliest times there are 
many such records. Borellus cites an instance, and there are many others, 
of pregnant women eating excrement with apparent relish. Tulpius, Sennert, 
Langius, van S^vieten, a Castro, and several others report depraved appe- 
tites. Several writers have seen avidity for human flesh in such females. 
Fournier *^ knew a woman with an appetite for the blood of her husband. 
She gently cut him while he lay asleep by her side and sucked blood 
from the wounds — a modern " Succubus." Pare** mentions the perverted 
appetites of pregnant women, and says that they have been known to eat 
plaster, ashes, dirt, charcoal, flour, salt, spices, to drink pure vinegar, and to 
indulge in all forms of debauchery. Plot^^^ gives the case of a woman who 
would gnaw and eat all the linen off her bed. Hufeland's Journal ^^'- records 
the history of a case of a woman of thirty-two, who had been married ten 
years, \vho acquired a strong taste for charcoal, and was ravenous for it. It 
seemed to cheer her and to cure a supposed dyspepsia. She devoured enormous 
quantities, preferring hard-wood charcoal. Bruyesinus "^ speaks of a woman 
who had a most perverted appetite for her own milk, and constantly drained 
her breasts ; Krafft^Ebing cites a similar case. Another case ^^^ is that of a 
pregnant woman who had a desire for hot and pungent articles of food, and 
who in a short time devoured a pound of pepper. Scheidemantel cites a 

a 780, 1888 ; and 596, 1888, Ivii., 635. b 476, 1878, 66. <= 272, 1892. 

d302, xiv.,624. e 618, 992. 


case in which the perverted appetite, originating in pregnancy, became 
permanent, but this is not the experience of most observers. The pregnant 
wife of a farmer in Hassfort-on-the-Main ate the excrement of her husband. "^ 

Many instances could be quoted, some in which extreme cases of poly- 
dipsia and bulimia developed ; these can be readily attributed to the in- 
creased call for liquids and food. Other cases of diverse new emotions can 
be recalled, such as lasciviousness, dirty habits, perverted thoughts, and, on 
the other hand, extreme piety, chastity, and purity of the mind. Some of 
the best-natured women are when pregnant extremely cross and irritable, 
and many perversions of disposition are commonly noticed in pregnancy. 
There is often a longing for a particular kind of food or dish for which no 
noticeable desire had been displayed before. 

Maternal Impressions. — Another curious fact associated with pregnancy 
is the apparent intlucuce of the emotions of the mother on the child in utero. 
Every one knows of the popular explanation of many birth-marks, their 
supposed resemblance to some animal or object seen by the mother during 
pregnancy, etc. The truth of maternal impressions, however, seems to be 
more firmly established by facts of a substantial nature. There is a natural 
desire to explain any abnormality or anomaly of the child as due to some 
incident during the period of the mother's pregnancy, and the truth is often 
distorted and the imagination lieavily drawn upon to furnish the satisfactory 
explanation. It is the customary speech of the dime-museum lecturer to 
attribute the existence of . some ''freak" to an episode in the mother's 
pregnancy. The poor " Elephant-man " firmly believed his peculiarity was 
due to the fact that his mother while carrying him in utero was knocked down 
at the circus by an elephant. In some countries the exhibition of monstrosi- 
ties is forbidden because of the supposed danger of maternal impression. 
The celebrated " iSiamese Twins " for this reason were forbidden to exhibit 
themselves for quite a period in France. 

We shall cite only a few of the most interesting cases from medical litera- 
ture. Hippocrates saved the honor of a princess, accused of adultery with 
a negro because she bore a black child, by citing it as a case of maternal 
impression, the husband of the princess having placed in her room a paint- 
ing of a negro, to the view of which she was subjected during the whole of 
her pregnancy. Then, again, in the treatise " De Superfoetatione " there 
occurs the following distinct statement : " If a pregnant woman has a long- 
ing to eat earth or coals, and eats of them, the infant which is born carries 
on its head the mark of these things." This statement, however, occurs in a 
work which is not mentioned by any of the ancient authorities, and is rejected 
by practically all the modern ones ; according to Ballantvne, there is, there- 
fore, no absolute proof that Hi]>pocrates was a believer in one of the most 
popular and long-persisting beliefs concerning fetal deformities. 

a Epheni. Physico-Medicorum, Leipzig, 1694, 212. 


In the explanation of heredity, Hippocrates '"^ states " that the body of the 
male as well as that of the female furnishes the semen. That which is weak 
(unhealthy) is derived from weak (unliealthy) parts, that which is strong 
(healthy) from strong (healthy) ])arts, aud the fetus will correspond to the 
quality of the semen. If the semen of one part come in greater quantity 
from the male than from the female, this part will resemble more closely the 
father ; if, however, it comes more from the female, the part will rather 
resemble the mother. If it bt- true that the semen comes from both parents, 
then it is im})ossible lor the whole body to resemble either the mother or the 
father, or neither the one nor the other in anything, but necessarily the child 
will reseuible both the one aud the other in something;'. The child Mill most 
resemble the one who coutributes most to the formati(jn of the parts." kSueh 
was the Hippocratic theory of generation and heredity, and it was ingen- 
iously used to explain the hereditary nature of certain diseases and mal- 
formations. For instance, in speaking of the sacred disease (epilepsy), 
Hippocrates says : " Its origin is hereditary, like that of other diseases ; for 
if a phlegmatic person be born of a phlegmatic, and a l)ilious of a bilious, 
and a phthisical of a ])hthisical, aud one having spleen disease of auother 
having disease of the spleen, what is to hinder it from happening that where 
the father and mother were subject to this disease certain of their offspring 
should be so affected also ? As the semen comes from all parts of the 
body, healthy particles will come from healthy parts, and unhealthy from 
unhealthy parts." 

--, According to Pare,^'^ Damascene saw a girl with long hair like a bear, 
Avliose mother had constantly before her a picture of the hairy St. John. 
Pare also appends an illustration showing the sup2)osed resemblance to a bear. 
Jonston ^^ quotes a case of Heliodorus ; it was an Ethiopian, who bv the 
effect of the imagination produced a white cliild. Pare ^^^ describes this case 
more fully : " Heliodorus says that Persina, Queen of Ethiopia, being 
impregnated by Hydustes, also an Ethiopian, Iwre a daughter with a white 
skin, and the anomaly was ascril^ed to the admiration that a picture of Andro- 
meda excited in Persina throughout the whole of the pregnancy." Van 
Helmont "^^'^ cites the case of a tailor's wife at Mechlin, who during a conflict 
outside her house, on seeing a soldier lose his hand at her door, gave birth to 
a daughter with one hand, the other hand being a bleeding stump ; he also 
speaks of the case of the wife of a merchant at Antwerp, Avho after seeing 
a soldier's arm shot off at the siege of Ostend gave birth to a daughter with 
one arm. Plot ''■'' speaks of a child bearing the figure of a mouse ; when 
pregnant, the mother had been much frightened by one of these animals. 
Gassendus ^^^ describes a fetus Avith the traces of a wound in the same location 
as one received by the mother. Tlie Lancet ^' speaks of several cases — 
one of a child with a face resembling a dog whose mother had l)een bitten ; one 
a 759, Oct., 1895. b 476, 186.3, ii., 27. 


of a child with one eye blue and the other black, whose mother during con- 
finement had seen a person so marked ; of an infant with iins as upper and 
lower extremities, the mother having seen such a monster ; and another, a 
child born with its feet covered with scalds and burns, whose mother had 
been badly frightened by fireworks and a descending rocket. There is ^ the 
history of a woman who while pregnant at seven months with her fifth child 
was bitten on the right calf by a dog. Ten weeks after, she bore a child with 
three marks corresponding in size and appearance to those caused by the dog's 
teeth on her leg. Kerr ^reports the case of a woman in her seventh month 
whose daughter fell on a cooking stove, shocking the mother, who suspected 
fatal burns. The woman was delivered two months later of an infant blistered 
about the mouth and extremities in a manner similar to the burns of her sis- 
ter. This infant died on the third day, but another was born fourteen 
months later with the same blisters. Inflammation set in and nearly all the 
fingers and toes sloughed off. In a subsequent confinement, long after the 
mental agitation, a healthy unmarked infant was born. 

Hunt*^' describes a case which has since become almost classic of a 
woman fatally burned, Avhen pregnant eight months, l)y her clothes catching 
fire at the kitchen grate. The day after the burns labor began and was ter- 
minated by the birth of a well-formed dead female child, apparently blis- 
tered and burned in extent and in places corresponding almost exactly to the 
locations of the mother's injuries. The mother died on the fi)urth day. 

AYebb'* reports the history of a negress who during a convulsion while 
pregnant fell into a fire, l)urning the whole front of the abdomen, the front 
and inside of. the thighs to the knees, the external genitals, and the left arm. 
Artificial delivery was deemed necessary, and a dead child, seemingly burned 
much like its mother, except less intensely, was delivered. There was also 
one large blister near the inner canthus of the eye and some large blisters 
about the neck and thmat which the mother did not show. There was no 
history of syphilis nor of any eruptive fever in the mother, who died on the 
tenth day with tetanus. 

J Graham^ describes a woman of thirty-five, the mother of seven children, 
wlio while pregnant was feeding some rabbits, when one of the animals 
jumped at her with its eyes "glaring" upon her, causing a sudden fright. 
Her child was born hydrocephalic. Its mouth and face were small and rab- 
bit-shaped. Instead of a nose, it had a fleshy growth | inch long by \ inch 
broad, directed upward at an angle of 45°. The space between this and 
the mouth was occupied by a body resembling an adult eye. Within this were 
two small, imperfect eyes which moved freely while life lasted (ten minutes). 
The child's integument was covered with dark, downy, short hair. The 
Avoman recovered and afterward bore two normal children. 

;i Gil, No. 19, May 7, 1842. b 104^ j^ly, 1857. c 124^ jgHl, Ixxxi., 186. 

d783, X., 419. 6 224, 1868, i., 51. 



Parvin mentions an instance of the influence of maternal impression in 
the causation of a hirgv, vivid, red mark or splotch on the face : "When the 
mother was in Ireland she was badly frightened by a fire in which some cat- 
tle were burned. Agtun, during the early months of her pregnancy she was 
frightened bv seeing another woman suddenlv light the fire with kerosene, 
and at that time became firmly impressed with the idea that her child would 
be marked." Parvin ^ also pictures the " turtle-man," an individual with de- 
formed extremities, who might be classed as an ectro- 
melus, perhaps as a phocomelus, or seal-like monster. 
According to the story, when the mother was a few 
weeks pregnant her husband, a coarse, rough fisherman, 
fond of rude jokes, put a large live turtle in the cup- 
board. In the twilight the wife went to the cupboard 
and the huge turtle fell out, greatly startling her by its 
hideous appearance as it fell suddenly to the floor and 
began to move vigorously. 

Copeland '^ mentions a curious case in which a woman 
was attacked by a rattlesnake when in her sixth month 
of pregnancy, and gave birth to a child whose arm ex- 
hibited the shape and action of a snake, and involun- 
tarily went through snake-like movements. The face 
and mouth also markedly resembled the head of a snake. 
The teeth were situated like a serpent's fangs. The 
mere mention of a snake filled the child (a man of 
twenty-nine) with great horror and rage, " particularly in the snake season." 
Beale ^' gives the history of a case of a child born with its left eye blackened 
as by a blow, whose mother was struck in a corresponding portion of the 
face eight hours before confinement. There is on record "^ an account of a 
young man of twenty-one suffering from congenital deformities attril)uted 
to the fact that his mother was frightened by a guinea-pig having been thrust 
into her face during pregnancy. He also had congenital deformity of the 
right auricle. At the autopsy, all the skin, tissues, muscles, and bones were 
found involved, Owen *^ speaks of a woman who Avas greatly excited ten months 
previously by a prurient curiosity to see what apjjearance the genitals of her 
brother presented after he had submitted to amputation of the penis on ac- 
count of carcinoma. The whole penis had been removed. The woman stated 
that from the time she had thus satisfied herself, her mind was unceasingly 
engaged in reflecting and sympathizing on the forlorn condition of her 
brother. AMiilc in this mental state she gave l)irth to a son whose penis was 
entirely absent, but who was otherwise well and likely to live. The other 
portions of the genitals were perfect and well developed. The appearance of 

Fig. 8. — The "turtle-man. 

a Internat. Med. Mag 
c 47(J, 1863, ii., 27. 

I'hila.. June. 1892. 

J 536, 1883, i., 381. 

b 218, 1839, 98. 
e 476, 1863, 25. 


the nephew and the uncle was identical. A most peculiar case ^ is stated by 
Clerc as occurring in the experience of Kiiss of Strasburg. A woman had 
a negro paramour in America with whom she had had sexual interccnirse 
several times. She was put in a convent on the Continent, where she stayed 
two years. On leaving the convent she married a white man, and nine 
months after she gave ])irth to a dark-skinned child. The supposition was 
that during her abode in the convent and the nine months subsequently she 
had the image of her black paramour constantly before her. Loin '^ speaks 
of a woman who was greatly impressed by the actions of a clown at a circus, 
and who brought into the world a child that resembled the fantastic features 
of tlie clown in a most striking manner. 

Mackay ^ describes five cases in wliich fright produced distinct marks on 
the fetus. There is a case mentioned '^ in which a pregnant woman was 
informed that an intimate friend had been thrown from his horse ; the 
immediate cause of death Mas fracture of the skull, produced by the corner 
of a dray against which the rider was thrown. The mother was profoundlv 
impressed by the circumstance, which was minutely described to her l)y an 
eye-witness. Her child at l)irth presented a red and sensitive area upon the 
scalp corresponding in location with the fatal injiuy in the rider. The 
child is now an adult woman, and this area upon the scalp remains red and 
sensitive to pressure, and is almost devoid of hair. Mastin of Mobile, 
Alabama, reports a curious instance of maternal impression. During the 
sixth month of the pregnancy of the mother her husband was shot, the ball 
passing out through the left breast. The woman was naturally much shocked, 
and remarked to Dr. ^Nlastin : " Doctor, my baby will be ruined, for when I 
saw the wound I put my hands over my face, and got it covered with blood, 
and I know my baby will have a bloody face." The child came to term 
without a bloody face. It had, however, a well-defined spot on the left 
breast just below the site of exit of the ball from its father's chest. The 
sp(^t was about the size of a silver half-dollar, and had elevated edges of a 
bright red color, and was quite visible at the distance of one hundred feet. 
The authors have had personal conununication with Dr. Mastin in regard to 
this case, which he considers the most positive evidence of a case of maternal 
impression that he has ever met. 

Paternal Impressions. — Strange as are the foregoing cases, those of pater- 
nal impression eclipse them. Several are on record, but none are of sufficient 
authenticity to warrant much discussion on the subject. Those below are 
given to illustrate the method of report. Stahl, quoted by Steinan, 1843, 
speaks of the case of a child, the father being a soldier who lost an eye in the 
war. The child was born with one of its eyes dried up in the orbit, in 
this respect presenting an appearance like that of the father. Schneider "^ 

a 239, July 7, 1873. b 645, 1879-80, xxxi. 

c 476, 1891, ii., 1388. d 844, 213. e 778, xxviii., 167. 


says a man whose wife was expecting confinement dreamt that his oldest 
son stood beside his bedside with his genitals mnch mutilated and bleeding. 
He awoke in a great state of agitation, and a few days later the wife was 
delivered of a ehild with exstrophy of the l)ladder. Hoare °- recites the 
curious story of a man who vowed that if his next child was a daughter he 
would never speak to it. The child proved to be a son, and during the 
whole of the father's life nothing could induce the son to speak to his father, 
nor, in fact, to any other male person, but after the father's death he talked 
fluently to both men and women. Clark '^ reports the liirth of a child whose 
father had a stiff knee-joint, and the child's knee was stiif and bent in exactly 
the same position as that of its father. 

Telegony. — The influence of the paternal seed on the physical and 
mental constitution of the child is well knowr. To designate this condition, 
Telegony is the word that was coined by Weismann in his " Das Keim- 
plasma," and he defines it as " Infection of the Germ," and, at another time, 
as " Those doubtful instances in which the offspring is said to resemble, not 
the father, bnt an early mate of the mother," — or, in other words, the alleged 
infiuence of a previous sire on the progeny produced l)y a subsequent one 
from the same mother. In a systematic discussion of telegony before 
the Royal Medical Society, Edinburgh, on ]Marcli 1, 1895,'^ Brunton 
Blaikie, as a means of making the definition of telegony plainer by practical 
example, prefaced his remarks by citing the classic example which first drew 
the attention of the modern scientific world to this phenomenon. The 
facts of this case were communicated in a letter from the Earl of ]Morton 
to the President of the Royal Society in 1821, and were as follows: 
In the year 1815 Lord Morton put a male quagga to a young chestnut mare 
of I Arabian blood, which had never before been bred from. The result was 
a female hybrid which resembled both parents. He now sold the mare to 
Sir Gore Ousley, who two years after she bore the hyljrid put her to 
a black Arabian horse. During the two following years she had two foals 
which Lord Morton thus describes : " They have the character of the Arabian 
breed as decidedly as can be expected when J-| of the blood are Arabian, 
and they are fine specimens of the breed ; but both in their color and in the 
hair of their manes they have a striking resemblance to the quagga. Their 
color is bay, marked more or less like the quagga in a darker tint. Both 
are distinguished by the dark line along the ridge of the back, tlie dark 
stripes across the forehand, and the dark bars across the back part of the 
legs." The President of the Royal Society saw the foals and verified Lord 
Morton's statement. 

"Herbert Spencer, in the Contemporary Review for May, 1893, gives 
several cases communicated to him by his friend Mr. Fookes, whom Spencer 
says is often appointed judge of animals at agricultural shows. After giving 

a 476, 1831-2, i., 441. b 548, xv., 258. c 759, July, 1895. 


various examples he goes on to say : ' A friend of mine near this had a 
vakiable Dachshund bitch, which most unfortunately had a litter by a stray 
sheep-dog. The next year the owner sent her on a visit to a pure Dachs- 
hund dog, l)ut the produce took quite as nuicli of the first father as the 
second, and the next year he sent her to anotlier Dachslumd, with the same 
result. Another case : A friend of mine in Devizes had a litter of puppies, 
unsought for, by a setter from a favorite pointer bitch, and after this she 
never bred any true pointers, no matter what the paternity was.' 

" Lord Polwarth, whose very fine breed of Border Leicesters is famed 
throughout Britain, and whose knowledge on the subject of breeding is great, 
says tliat ' In sheep we always consider that if a ewe breeds to a Shrop ram, 
she is never safe to breed pure Leicesters from, as dun or colored legs are 
apt to come even when the sire is a pure Leicester. This has been proved 
in various instances, but is not invariable.' " 

Hon. Henry Scott says : " Dog-breeders know this theory well ; and if a 
pure-ljred bitch happens to breed to a dog of another breed, she is of little 
use for breeding pure-bred puppies afterward. Animals which produce 
large litters and go a short time pregnant show this throwing back to 
previous sires far more distinctly than others — I fancy dogs and pigs most 
of all, and probably horses least. The influence of previous sires may be 
carried into the second generation or further, as I have a cat now which 
appears to be half Persian (long hair). His dam has very long hair and 
every appearance of being a half Persian, whereas neither have reallv any 
Persian blood, as far as I know, but the grand-dam (a very smooth-haired 
cat) had several litters by a half-Persian tom-cat, and all her produce since 
have showed the influence retained. The Persian tom-cat died many years 
ago, and was the only one in the district, so, although I cannot be absolutely 
positive, still I think this case is really as stated." 

Breeders of Bedlington terriers wish to breed dogs with as powerful jaws 
as possible. In order to accomplish this they put the Bedlington terrier 
bitch first to a bull-terrier dog, and get a mongrel litter which they destroy. 
They now put the bitch to a Bedlington terrier dog and get a litter of 
puppies which are practically pure, but have much stronger jaws than they 
would otherwise have had, and also show much of the gameness of the bull- 
terrier, thus proving that physiologic as well as anatomic characters may be 
transmitted in this way. 

After citing the foregoing examples, Blaikie directs his attention to man, 
and makes the following interesting remarks : — 

" We might expect from the foregoing account of telegony amongst ani- 
mals that whenever a black woman had a child to a white man, and then 
married a black man, her subsequent children would not be entirely black. 
Dr. Robert Balfour of Surinam in 1851 wrote to Harvey that he was con- 
tinually noticing amongst the colored population of Surinam ' that if a negress 


had a child or children hv a white, and afterward frnitful intercourse with 
a negro, the latter otisprinii" had o-enerally a liohter color than the parents.' 
But, as far a> I know, this is the only instance of this ol)servation on record. 
Herbert Spencer has shown that when a pure-bred animal breeds with an 
animal of a mixed breed, the otfs})ring resembles much more closely the pa- 
rent of i)ure blood, and this may explain why the circumstance recorded by 
Balfour has been so seldom noted. For a negro, who is of very pure blood, 
will naturally have a stronger iuHuence on the subsecjuent progeny than an 
Anglo-Saxon, ^vho comes of a mixed stock. If this he the correct explana- 
tion, we should expect that when a white woman married first a black man, 
and then a white, the children by the white husband would be dark colored. 
Unfortunately for the proof of telegony, it is very rare that a white Avoman 
does marry a black man, and then have a white as second husband ; never- 
theless, we have a fair nunil)er of recorded instances of dark-colored chil- 
dren l)eing born in the above way of white jiarents. 

"Dr. Harvey mentions a case in which 'a young woman, residing in 
Edinburgh, and born of Avhite (Scottish) parents, but whose mother, some 
time previous to her marriage, had a natural (mulatto) child by a negro man- 
servant in Edinburgh, exhibits distinct traces of the negro. Dr. Simpson 
— aftervianl Sir James Simpson — Avhose patient the young woman at one 
time wasj has had no recent ojiportiuiities of satisfving himself as to the pre- 
cise extent to which the negro character prevails in her features ; but he 
recollects being struck with the resemblance, and noticed particularly that 
the hair had the qualities characteristic of the negro.' Herbert Spencer got 
a letter from a ' distinguished correspondent ' in the United States, who said 
that children by white parents had l)een ' repeatedly ' observed to show traces 
of black blood when the women had had previous connection with (/. e., a 
child by) a negro. Dr. Youmans of New York interviewed several medi- 
cal professors, who said the above was ' generally accepted as a fact.' Prof. 
Austin Flint, in ' A Text-book of Human Physiology,' mentioned this fact, 
and when asked about it said : ' He had never heard the statement ques- 

"But it is not only in relation to color that we find telegony to have 
been noticed in the human subject. Dr. ^Nliddleton ^lichel gives a most in- 
teresting case in the American Journal of the Medical Sciences for 1868 : 
^ A black woman, mother of several negro children, none of whom were de- 
formed in any particular, had illicit intercourse with a white man, by Mhom 
she became pregnant. During gestation she manifested great uneasiness of 
mind, lest the Ijirth of a nuilatto oifspring should disclose her conduct. . . . 
It so happened that her negro husband ])ossessed a sixth digit on each hand, 
but there was no peculiarity of any kind in the white man, yet when the 
mulatto child was born it actually presented the defi^-mity of a supernume- 
rary finger.' Taruffi, the celebrated Italian teratologist, in speaking of the 


subject, says : ' Our knowledii:e of this strange fact is by no means recent, 
for Fienus, in 1608, said that most of the children born in adultery have a 
greater resemblance to the legal than to the real father' — an observation that 
was confirmed by the philosopher Vanini and by the naturalist Ambrosini. 
From these observations conies the proverb : ' Filium ex adultera exeusare 
matrem a culpa.' Osiander has noted telegony in relation to moral qualities 
of children by a second marriage. Harvey said that it has long been known 
that the children by a second husband resemble the first husband in features, 
mind, and disposition. He then gave a case in which this resemblance was 
very well marked. Orton, Burdach (Traite de Physiologic), and Dr. Will- 
iam Sedgwick have all remarked on this physical resemblance ; and Dr. 
Metcalfe, in a dissertation delivered before this society in 1855, observed 
that in the cases of widows remarrying the children of the second marriage 
frequently resemble the first husband. 

"An observation probal)ly having some bearing on this subject was made 
by Count de Stuzeleci (Harvey, loc. elf.). He noticed that when an aborig- 
inal female had had a child by a European, she lost the power of conception 
by a male of her own race, but could produce children by a white man. He 
believed this to be the case with many aboriginal races ; but it has been dis- 
proved, or at all events proved to be by no means a universal law, in every 
case except that of the aborigines of Australia and New Zealand. Dr. 
William Sedgwick thought it probable that the unfruitfulness of prostitutes 
might in some degree be due to the same cause as that of the Australian 
aborigines who have had children by white men. 

" It would seem as though the Israelites had had some knowledge of 
telegony, for in Deuteronomy we find that when a man died leaving no issue, 
his wife was commanded to marry her husband's brother, in order that lie 
might ' raise up seed to his brother.' " 

AVe must omit the thorough inquiry into this subject that is offered liy 
Mr. Blaikie. The explanations put forward have always been on one of 
three main lines : — 

(1) The imagination-theory, or, to quote Harvey : " Due to mental causes 
so operating either on the mind of the female and so acting on her repro- 
ductive powers, or on the mind of the male parent, and so influencing the 
qualities of his semen, as to modify the nutrition and development of the 

(2) Due to a local influence on the reproductive organs of the mother. 

(3) Due to a general influence through the fetus on the mother. 

Antenatal Pathology. — We have next to deal with the diseases, acci- 
dents, and operations that affect the pregnant uterus and its contents ; these 
are rich in anomalies and facts of curious interest, and have been recog- 
nized from the earliest times. In the various works usually grouped 
together under the general designation of " Hippocratic " are to be found 


the earliest opinions upon the suhject of antenatal pathology which the 
niedieal liteniture of Greece has handed down to modern times. That there 
were medical writers before the time of Hi])pocrates cannot be doubted, and 
that the works ascribed to the "Father of Medicine" were immediately fol- 
lowed by those of other physicians, is likewise not to be questioned ; but 
whilst nearly all the writings prior to and after Hippocrates have been long 
lost to the world, most of those that were written by the Coan physician and 
his followers have been almost miraculously })reserved. As Littre puts it, 
" Les ecrits hip})ocrati(iues demeurent isoles au milieu des debris de I'antique 
litterature medicale." — (Ballantyne.) 

The first to be considered is the transmission of contagious disease 
to the fetus in utero. The first disease to attract attention was small- 
pox. Devilliers, Blot, and Depaul all speak of congenital small-pox, the 
child born dead and showing evidences of the typical small-pox pustulation^ 
with a history of the mother having been infected during pregnancy. 
AVatson -"* reports two cases in which a child in utero had small-pox. In the 
first case the mother was infected in pregnancy ; the other was nursing a 
patient when seven months pregnant ; she did not take the disease, although 
she had been infected many months before. Mauriceau ^^^ delivered a woman 
of a healthy child at full term after she had recovered from a severe attack 
of this disease during the fifth month of gestation. Mauriceau supposed 
the child to be immune after the delivery. Vidal reported to the French 
.Vcademy of ]\Iediciue, ^lay, 1871, the case of a woman who gave birth to 
a living child of about six and one-half months' maturation, which died some 
hours after birth covered with the pustules of seven or eight days' eruption. 
The pustules on the fetus were well umbilicated and typical, and could have 
been nothing but those of small-pox ; besides, this disease was raging in the 
neighljorhood at the time. The mother had never been infected before, and 
never was subsequently. Both parents were robust and neither of them 
had ever had syphilis. About the time of conception, the early part of 
December, 1870, the father had suffered from the semiconfluent type, but the 
mother, who had been vaccinated when a girl, had never been stricken 
either during or after her husband's sickness. Quirke'' relates a peculiar 
instance of a child born at midnight, whose mother was covered with the 
eruption eight hours after delivery. The child Avas healthy and showed no 
signs of the contagion, and was vaccinated at once. Although it remained 
with its mother all through the sickness, it continued well, with the excep- 
tion of the ninth day, when a slight fever due to its vaccination appeared. 
The mother made a good recovery, and the author remarks that had the 
child Ijeen born a short time later, it would most likely have been infected. 

Ayer '^ reports an instance of congenital variola in twins. Chantreuil ^ 

a 629, 1743-50, 1043. >' 224, 1886, i., 201. 

c 218, 1851, xliv., 397. d 363, 1870, xliii., 173. 


speaks of a woman pregnant with twins who aborted at five and a lialf 
months. One of the fetuses showed distinct signs of congenital variola, 
although the mother and other fetus were free from any symptoms of the 
disease. In 1853 Charcot reported the birth of a premature fetus present- 
ing numerous variolous pustules together with ulcerations of the derm and 
mucous membranes and stomach, although the mother had convalesced of 
the disease some time before. Mitchell'^ describes a case of small-pox occur- 
ring three davs after birth, the mother not having had the disease since 
childhood. Shertzer '' relates an instance of confluent small-pox in the eighth 
month of pregnancy. The child was born with the disease, and both motiier 
and babe recovered. Among many others oflering evidence of variola in 
utero are Degner, Derham, John Hunter, Blot, Bulkley, Welch, Wright, 
Digk, Forbes, Marinus, and Bouteiller. 

Varicella, Measles, Pneumonia, and even Malaria are reported as 
having been transmitted to the child in utero. Hubbard ° attended a woman 
on March 17, 1878, in her seventh accouchement. The child showed the 
rash of varicella twenty-four hours after birth, and passed through the regu- 
lar course of chicken-pox of ten days' duration. The mother had no signs 
of the disease, but the children all about her were infected. Ordinarily the 
period of incubation is from three to four days, with a premonitory fever of 
from twenty-four to seventy-two hours' duration, when the rash appears ; 
this case must therefore have been infected in utero. Lomer'^ of Ham- 
burg tells of the case of a woman, twenty-two years, unmarried, pregnant, 
who had measles in the eighth month, and who gave birth to an infant with 
measles. The mother was attacked with pneumonia on the fifth day of her 
puerperium, but recovered ; the child died in four weeks of intestinal 
catarrh. Gautier*^ found measles transmitted from the mother to the fetus 
in (] out of 11 cases, there being 2 maternal deaths in the 11 cases. 

Netter^ has observed the case of transmission of pneumonia from a 
mother to a fetus, and has seen two cases in which the blood from the uterine 
vessels of patients with pneumonia contained the pneumococcus. Wallick s 
collected a number of cases of pneumonia occurring during pregnancy, show- 
ing a fetal mortality of 80 per cent. 

Felkin'' relates two instances of fetal malaria in which the infection was 
probably transmitted by the male parent. In one case the father near 
term suffered severely from malaria ; the mother had never had a chill. 
The violent fetal movements induced labor, and the spleen was so large as 
to retard it. After birth the child had seven malarial paroxysms but re- 
covered, the splenic tumor disappearing. 

The modes of infection of the fetus by syphilis, and the infection of 
the mother, have been well discussed, and need no mention here. 

a 124, 1830, vii., 555. b 547^ iv., 756. c 004, 1878, i., 822. d 261, 1889. 

e 140, 1879, 321. f 300, No. 22, 1889. S 140, 1889, 439. ^318, June, 1889. 


There lias been mncli diseussion on the effects on the fetus in utero 
of medicine administered to the pregnant mother, and the opiuion.s as 
to the reliability of this medication are so varied that we are in doubt as to a 
satisfactory conclusion. The effects of drugs administered and eliminated 
by the manunary glands and transmitted to the child at the breast are 
well known, antl have been witnessed by nearly every physician, and, as 
in cases of strong metallic purges, etc., need no other than the actual test. 
However, scientific experiments as to the efficacy of fetal therapeutics have 
been made from time to time with varying results. 

Gusserow of Strasbourg tested for iodin, chloroform, and salicylic acid 
in the blood and secretions of the fetus aftc maternal administration just 
before death. In 14 cases in which iodin had been administered, he 
examined the fetal urine of 11 cases; in 5 iodin was present, and in the 
others, absent. He made some similar experiments on the lower animals. 
Benicke reports having given salicylic acid just before birth in 25 cases, and 
in each case finding it in the urine of the child shortly after birth. 

At a discussion held in Xew York some years ago as to the real effect on 
the fetus of giving narcotics to the mother. Dr. Gaillard Thomas was almost 
alone in advocating that the effect was quite visil)le. Fordyce Barker was 
strongly on the negative side. Henningand Ahlfekl, two German observers, 
vouch for the opinion of Thomas, and Thornburn states that he has witnessed 
the effect of nux vomica and strychnin on the fetus shortly after birth. 
Over fifty years ago, in a memoir on " Placental Phthisis," Sir James Y. 
Simpson advanced a new idea in the recommendation of potassium chlorate 
during the latter stages of pregnancy. The efficacy of this suggestion is 
known, and whether, as Simpson said, it acts by supjilying extra oxygen to 
the blood, or whether the salt itself is conveyed to the fetus, has never 
been definitely settled. 

McOlintock,^ who has been a close observer on this subject, reports some 
interesting cases. In his first case he tried a mixture of iron perchlorid and 
potassium chlorate three times a day on a woman who had borne three dead 
children, with a most successful result. His second case failed, but in a 
third he was successful by the same medication with a woman who had 
before borne a dead child. In a fourth case of unsuccessful pregnancy for 
three consecutive births he was successful. His fifth case was extra- 
ordinary : It was that of a woman in her tenth pregnancy, who, with one 
exception, had always borne a dead child at the seventh or eighth month. 
The one exception lived a few hours only. Under this treatment he was 
successful in carrying the woman safely past her time fi)r miscarriage, and 
had every indication for a normal birth at the time of report. Thornburn 
believes that the administration of a tonic like strychnin is of benefit to a 
fetus which, by its feeble heart-beats and movements, is thought to be un- 

a 224, 1877, ii., 513. 


healthy. Porak'* has recently investigated the passage of substances foreign 
to the organism through the ])lacenta, and offers an excellent paper on this 
subject, which is quoted in brief in a contemporary number of Terato- 

In this important paper, Porak, after giving some historical notes, 
describes a long series of experiments performed on the guinea-pig in order 
to investigate the passage of arsenic, copper, lead, mercury, phosphorus, 
alizarin, atropin, and eserin through the placenta. The placenta shows 
a real affinity for some toxic substances ; in it accunudate copper and mer- 
cury, but not lead, and it is therefore through it tliat the poison reaches the 
fetus ; in addition to its pulmonary, intestinal, and renal functions, it fixes 
glycogen and acts as an accumulator of poisons, and so resembles in its action 
the liver ; therefore the organs of the fetus possess only a potential activity. 
The storing up of poisons in the placenta is not so general as the accunuda- 
tion of them in tlie liver of the mother. It may be asked if the ])laceiita 
does not form a barrier to the passage of poisons into the circulation of the 
fetus ; this would seem to be demonstrated by mercury, which was always 
found in the placenta and never in the fetal organs. In poisoning by lead 
and copper the accumulation of the poison in the fetal tissues is greater than 
in the maternal, jx-rhaps from differences in assimilation and (lisassimilatif)n 
or from greater diffusion. Whilst it is not an impermeable barrier to the ])as- 
sage of poisons, the placenta offers a varying degree of obstruction : it allows 
copper and lead to pass easily, arsenic with greater difficulty. The accumu- 
lation of toxic substances in the fetus does not follow the same law as in the 
adult. They diffuse more widely in the fetus. In the adult the liver is the 
chief accumulatorv organ. Arsenic, which in the nKjther elects to accunm- 
late in the liver, is in the fetus stored up in the skin ; copper accumulates 
in the fetal liver, central nervous system, and sometimes in the skin ; lead, 
which is found specially in the maternal liver, l)ut also in the skin, lias been 
observed in the skin, liver, nervous centers, and elsewhere in the fetus. The 
frequent presence of poisons in the fetal skin demonstrates its physiologic 
importance. It has probably not a very marked influence on its health. 
On the contrary, accumulation in the ])lacenta and nerve centers explains 
the pathogenesis of abortion and the birth of dead fetuses (" mortinatalite "). 
Copper and lead did not cause abortion, but mercury did so in two out of 
six cases. Arsenic is a powerful abortive agent in the guinea-pig, probably 
on account of placental hemorrhages. An important deduction is that whilst 
the placenta is frequently and seriously affected in syphilis, it is also the 
special seat for the accumulation of mercury. May this not explain its 
therapeutic action in this disease ? The marked accumulation of lead in the 
central nervous system of the fetus explains the frequency and serious char- 
acter of saturnine encephalopathic lesions. The presence of arsenic in the 
a Archives de M6d. experimentale et d' Anatomic path., March, 1894, p. 192. 



fetal skin alone gives an explanation of the therapeutic results of the adniiuis- 
tratiou of this substance in skin diseases. 

Intrauterine amputations are of interest to the medical man, par- 
ticulai'ly those cases in which the accident has happened in early pregnancy 
and the child is born with a very satisfactory and clean stump. Mont- 
gomery/'' in an excellent paper, advances the theory, which is very plausible, 
that intrauterine amputations are caused by contraction of bands or mem- 
branes of organized lymph encircling the limb and producing ain|)utation l)y 
the same process of disjunctive atrophy that the surgeons induce by ligature. 
AVeinlechner'^ speaks of a case in Avhich a man devoid of all four extremi- 
ties was exhibited before the Vienna Medical Society. The amputations 
were congenital, and on the right side there was a very small stump of the 
upper arm remaining, admitting the attachment of an artificial apparatus. 
He was twenty-seven years old, and able to write, to thread a needle, pour 
water out of a bottle, etc. Cook*^ speaks of a female child born of Indian 
parents, the fourth birth of a mother twenty-six years old. Tlie child 
weighed 5i pounds ; the circumference of the head was 14 inches and that of 
the truidv 1 3 inches. The upper extremities consisted of perfect shoulder joints, 
but only \ of each humerus was present. Both sides showed evidences of 

amputation, the cicatrix on the right side 
being 1 inch long and on the left \ 
inch long. The right lower limb was 
merely a fleshy corpuscle | incli wide and 
\ inch long ; to the posterior edge was 
attached a body resembling the little toe 
of a newly-born infant. On the left side 
the limb was represented by a fleshy cor- 
puscle 1 inch long and ^ inch in circumfer- 
ence, reseml)ling the great toe of an in- 
fant. There was no history of shock or 
injury to the mother. The child presented by the breech, and by the ab- 
sence of limbs caused much difficulty in diagnosis. The three stages of labor 
were one and one-half hours, forty-five minutes, and five minutes, respect- 
ively. The accompanying illustration (Fig. 9) shows the ap])earance of the 
limbs at the time of report. 

Figure 10 represents a negro l)oy, the victim of intrauterine amputation, 
who learned to utilize his toes for many purposes. The illustration shows 
his mode of holding his pen. 

There is an instance reported '^ in which a child at full term was liorn 
with an amputated arm, and at the age of seventeen the stump was scarcely 
if at all smaller than the other. Blake ® speaks of a case of congenital 

Fi's- 9. — Iiitrautcrino anipiitaticjii (Cook). 

a :^09, 18.'52. 

d 222, Oct., 1837. 

b 118, Jau. 22, 1878. 

c 224, 1890, i., 1360. 
e 218, Dec. 20, 1894. 



amputation of both the upper extremities. Gillilam =' mentions a case that 
shows the deleterious influence of even the weight of a fetal limb resting on 
a cord or band. His case was that of a fetus, the })roduct of a miscarriage 
of traumatic origin ; the soft tissues were almost cut through and the bone 
denuded ])v the limb resting on one of the two umbilical cords, not encir- 
cling it, but in a sling. The cord was deeply imbedded in the tissues. 

The codings of the cord are not limited to compression about the extremi- 
ties alone, but may even decapitate the head by being firndy wrapped several 
times about the neck. According to Ballantyne, '"'•' there is in the treatise 
De Octimestri Partu, l)y Hip- 
pocrates, a reference to coiling 
of the umbilical cord round the 
neck of the fetus. This coiling 
was, indeed, regarded as one of 
the dangers of the eighth month, 
and even the mode of its pro- 
duction is described. It is said 
that if the cord l)e extended 
along one side of the uterus, 
and the fetus lie more to the 
other side, then when the cn/- 
bide is performed the funis must 
necessarily form a loo]> round 
the neck or chest of the infant. 
If it remain in this position, it 
is further stated, the mother will 
suffer later and the fetus will 
either perish or be born with 
difficulty. If the Hi])pocratic 
writers knew that this coiling is 
sometimes quite innocuous, they 
did not in any place state the fact. 

The accompanying illustrations (Fig. 11) show the different ways in which 
the funis may be coiled, the coils sometimes being as many as 8. 

Bizzen^' mentions an instance in which from strangulation the head of a 
fetus was in a state of putrefaction, the funis being twice tiglitly bound 
around the neck. Cleveland,*^^ Cuthbert,*^ and Germain •" report analogous 
instances. Matthyssens ^ observed the twisting of the funis about the arm 
and neck of a fetus the body of which was markedly wasted. There was 
complete absence of amniotic fluid during labor. BlumenthaU' presented to the 
New York Pathological Society an ovum within which the fetus was under- 

a 274, 1872, iii., 230. l> 124, 1852, xxxiii., 565. c 778, xiii., 1. tl 610, 1874-5. 
e 362, ix., 567. f Auu. Soc. de med. d'Anvers, 1842, 372. g 538, 1871, vi., 278. 

Fig. 10. — Intrauterine amputation. 



going intrauterine decapitation. Bucluinan ^ describes a case illustrative of 
the etiology of spontaneous amputation of limbs in ntero, Nebinger ^ reports 
a case of abortion, showing commencing amputation of the left thigh from 
being encircled by the funis. Tlie death of the fetus was probably due to 
compression of the cord. Owen'^ mentions an instance in which the left arm 
and hand of a fetus were found in a state of putrescence from strangulation, 
the funis being tightly bound aroiuid at the upper part. Simpson'^ pub- 
lished an article on spontaneous amputation of the forearm and rudimentary 
regeneration of the hand in the fetus. Among other contributors to this 

Fig. 11. — Coiling of the cord. 

subject are Avery, Boncour, Brown, Ware, Wrangell, Young, Nettekoven, 
Martin, Macan, Leopold, Hecker, Giinther, and Friedinger. 

Wygodzky ® finds that the greatest number of coils of the umbilical cord 
ever found to encircle a fetus are 7 (BaudelQcque), 8 (Crede), and 9 
(Miiller and Gray). His own case was observed tliis year in Wilua. The 
patient was a primipara aged twenty. The last period was seen on 
May 10, 1894. On February 19th the fetal movements suddenly ceased. 
On the 20th pains set in about two weeks before term. At noon turbid 

a 774, 1839, x., 41. l> 124, 1867, liv., 129. c 656, 1851, 573. 

d Month. Jour. Med. Sc, Edin., 1848. e 261; and quoted 545, Feb. 29, 1896. 


liquor amnii escaped. At 2 p. m., on examination, Wygodzky defined a 
dead fetus in left oeeipito-anterior presentation, very biuh in the inlet. The 
OS was nearly completely dilated, the pains strong. By 4 p. m. the head 
was hardly engaged in the pelvic cavity. At 7 p. .ai. it neared the outlet 
at the height of each pain, but retracted immediately afterward. After 10 
p. m. the pains grew weak. At midnight AVygodzky delivered the dead 
child bv expression. Xot till then was the cause of delay clear. The funis 
was ver\^ tense and coiled 7 times round the neck and once round the left 
shoulder ; there was also a distinct knot. It measured over 65 inches in 
length. The fetus was a male, slightly macerated. It weighed over 5 pounds, 
and was easily delivered entire after division and unwinding of the funis. 
No marks remained on the neck. The placenta followed ten minutes later 
and, so far as naked-eye experience indicated, seemed healthy. 

Intrauterine fractures are occasionally seen, but are generally the re- 
sults of traumatism or of some extraordinary muscular efforts on the part 
of the mother. A blow on the abdomen or a fall may cause them. The 
most interesting cases are those in which the fractures are nudtiple and the 
causes unknown. Spontaneous fetal fractures have been discussed thor- 
oughlv, and the reader is referred to any responsible text-book for the theo- 
ries of causation. Atkinson,'' De Luna,^ and Keller report intrauterine 
fractures of the clavicle. Filippi'^ contributes an extensive paper on the 
medicolegal aspect of a case of intrauterine fracture of the os cranium. 
Braun of Vienna reports a case of intrauterine fracture of the humerus and 
femur. Kodrigue'^ describes a case of fracture and dislocation of the hu- 
merus of a fetus in utero. Gaultier** reports an instance of fracture of both 
femora intrauterine. Stanley, Vanderveer, and Young cite instances of in- 
trauterine fracture of the thigh ; in the case of Stanley the fracture occurred 
during the last week of gestation, and there was rapid union of the frag- 
ments during lactation. Danyau, Proudfoot, and Smith '' mention intrauterine 
fracture of the tibia ; in Proudfoot's case there was congenital talipes talus. 

Dolbeaus describes an instance in which multiple fractures were found in 
a fetus, some of which were evidently postpartum, while others were assuredly 
antepartum. Hirschfeld ^ describes a fetus showing congenital multiple frac- 
tures. Gross ^^'^ speaks of a wonderful case of Chaupier in which no less than 
113 fractures were discovered in a child at birth. It survived twenty- four 
hours, and at the postmortem examination it was found that some were 
already solid, some uniting, whilst others were recent. It often happens 
that the intrauterine fracture is well united at birth. There seems to be a 
peculiar predisposition of the bones to fracture in the cases in which the frac- 
tures are multiple and the cause is not apparent. 

a 545, 1859-60, iii., 532. ^ 124, 1873, Ixvi., 282. c Imparziale, Firenze, 1879, xix. 

d 124, 1854, xxvii., 272. e 458, 1819, 81. f 779, xviii., 215. 

g 242, xxxviii., 126. ^ 363, xxx., 291. 



The results to the fetus of injuries to the pregnant mother are most 
'live'i'.sitiod. In soiiio instance?? the niarveloii.s escape of any serious conse- 
quences of one or both is ahiiost incredible, while in others the slightest 
injury is fatal. Guillcniont " cites the instance of a Avonian who was killed 
by a stroke of lightning, but whose fetus was saved ; while Fabricius Hil- 
danus ^ describes a case in which there was perforation of the head, fracture 
of the skull, and a wound of the groin, due to sudden starting and agony of 
terror of the mother. Here there was not the slightest history of any exter- 
nal violence. 

It is a well-known fact that injuries to the pregnant mother show visible 
effects on the person of the fetus. The older writers kept a careful record 
of the anomalous and extraordinary injuries of this character and of their 
effects. Brendelius tells us of hemorrhage from the mouth and nose of the 
fetus occasioned by the fall of the mother ; Buchner ^ mentions a case of 
fracture of the cranium from fright of the mother ; Reuther describes a con- 
tusion of the OS sacrum and abdomen in the mother from a fall, with fracture 
of the arm and leg of the fetus from the same cause ; Sachse ^ speaks of a 
fractured tibia in a fetus, caused h\ a fall of the mother; Slevogt® relates 
an instance of rupture of the abdomen of a fetus by a fall of the mother ; 
the Ephemerides contains accounts of injuries to the fetus of this nature, 
and among others mentions a stake as having been thrust into a fetus in 
utero ; Verduc ^ offers several examples, one a dislocation of the fetal fiot 
from a maternal fall; Plocquet ^•^''' gives an instance of fractured femiu- ; 
AValther ^ describes a case of dislocation of the vertebra? from a fall ; and 
there is also a case "^ of a fractured fetal vertebra from a maternal fall. There 
is recorded^ a fetal scalp injury, together with clotted blood in the hair, after 
a fall of the mother. Autenrieth describes a wound of the pregnant uterus, 
which had no fatal issue, and there is also another similar case on record. J 

The modern records are much more interesting and wonderful on this 
subject than the older ones. Richardson ^^** speaks of a woman falling down 
a few weeks before her delivery. Her pelvis was roomy and the birth was 
easy ; but the infant was found to have extensive wounds on the back, reach- 
ing from the 3d dorsal vertebra across the scapula, along the back of the 
humerus, to within a short distance of the elbow. Part of these wounds 
were cicatrized and part still granulating, which shows that the process of 
reparation is as active in utero as elsewhere. 

Injuries about the genitalia would naturally be expected to exercise 
some active intiuence on the uterine contents ; l)ut there are many instances 
reported in which the escape of injury is marvelous. Gibb ^ speaks of a 
woman, about eight months pregnant, who fell across a chair, lacerating her 

a Lyons, 1590. 'j 334, cent, v., obs. 3. c Miscel. 1728, 1026. <1 450, l. xi. 

e 282, ann. x., 172. f 799^ T. i., 197. g 815, ob.s. 50. h 504^ v.. 326. 

i 462, T. xxi. J 106, 1712, 454. ^ 476, 1858, i. 


genitals and causing an escape of liquor aninii. There was regeneration of 
this fluid and delivery beyond term. The labor was tedious and took place 
two and a half months after the accident. The mother and the female child 
did well. Purcell "^ reports death in a pregnant woman from contused wound 
of the vulva. ^Slorland '' relates an instance of a woman in the fifth month 
of her second pregnancy, who fell on the roof of a woodshed by slipping 
from one of the steps by which she ascended to the roof, in the act of hang- 
ing out some clothes to dry. She suffered a wound on the internal surface 
of the left nympha 1 J inch long and i inch deep. She had lost about three 
quarts of blood, and had applied ashes to the vagina to stop the bleeding. 
She made a recovery by the twelfth day, and the fetal sounds were plainly 
audible. Cullingworth " speaks of a woman who, during a quarrel with her 
husl)and, was pushed away and fell between two chairs, knocking one of them 
over, and causing a trivial wound one inch long in the vagina, close to the 
entrance. She screamed, there was a gush of blood, and she soon died. 
The uterus contained a fetus three or four months old, with the membranes 
intact, the maternal death being due to the varicosity of the pregnant 
pudenda, the sliglit injury being sufficient to produce fatal hemorrhage. 
Carhart'^ describes the case of a pregnant woman, who, while in the stoop- 
ing position, milking a cow, was impaled through the vagina by another 
cow. The child was born seven days later, with its skull crushed by the 
cow's horn. The horn had entered the vagina, carrying the clothing with it. 

There are some marvelous cases of recovery and noninterference with 
pregnancy after injuries from horns of cattle. Corey *^ speaks of a woman 
of thirty-five, three months pregnant, weighing 135 pounds, who was horned 
by a cow through the abdominal parietes near the hypogastric region ; slie 
was lifted into the air, carried, and tossed on the ground by the infuriated 
animal. There was a wound consisting of a ragged rent from above the os 
pubis, extending obliquely to the left and upward, through which protruded 
the great omentum, the descending and transverse colon, most of the small 
intestines, as well as the ]\vloric exti^emity of the stomach. The great omen- 
tum was mangled and comminuted, and bore two lacerations of two inches 
each. The intestines and stomach were not injured, but there was consider- 
able extravasation of blood into the abdominal cavity. The intestines were 
cleansed and an unsuccessful attempt was made to replace them. The intes- 
tines remained outside of the body for two hours, and the great omentum 
was carefully spread out over the chest to prevent interference with the 
efforts to return the intestines. The patient remained conscious and calm 
throughout ; finally deep anesthesia was produced by ether and chloroform, 
three and a half hours after the accident, and in twenty minutes the intes- 
tines were all replaced in the abdominal cavity. The edges were pared, 
sutured, and the wound dressed. The Avoman was placed in bed, on the 

a 313, 1870. b 218, 1858-9. c 52I, 1885. d 760, 1884. e 133, 1878. 


right side, and morphin was administered. The sutures were removed on 
the ninth da} , and the wound had healed except at the point of penetration. 
The woman was discharged twenty days after, and, incredible to relate, was 
delivered of a well-developed, full-term child just two hundred and two 
days from the time of the accident. Both the mother and child did well. 

Luce ^ speaks of a pregnant woman who was horned in the lower part 
of the abdomen by a cow, and had a subsequent protrusion of the intestines 
through the \vound. After some minor complications, the w^ound healed 
fourteen weeks after the accident, and the woman was confined in natural 
labor of a healthy, vigorous child. In this case no blood was found on 
the cow's horn, and the clothing was not torn, so that the wound nuist 
have been made by the side of the horn striking the greatly distended 

Richard,^ quoted also by Tiifany,^^'^ speaks of a woman, twenty-two, who 
fell in a dark cellar with some empty bottles in her hand, suifering a wound 
in the al)domen '1 inches above the navel on the left side 8 cm. long. 
Through this wound a mass of intestines, the size of a man's head, protruded. 
Both the mother and the child made a good convalescence. Harris ^ cites 
the instance of a woman of thirty, a multipara, six months pregnant, who 
was gored by a cow ; her intestines and omentum protruded through the rip 
and the uterus was bruised. There was rapid recovery and deliver}' at 
term. Wetmore of Illinois saw a woman who in the summer of 1860, 
when about six months pregnant, was gored by a cctw, and the large 
intestine and the omentum protruded through the wound. Three hours 
after the injury she was found swathed in rags wet with a compound 
solution of whiskey and camphor, with a decoction of tobacco. The intes- 
tines were cold to the touch and dirty, but were Abashed and replaced. The 
aijdomen was sewed up with a darning needle and black linen thread ; the 
woman recovered and bore a healthy child at the full maturity of her gesta- 
tion.^' Crowdace** speaks of a female pauper, six months pregnant, who 
was attacked by a buffalo, and suffered a wound about 1| inch long and \ 
inch wide just above the umbilicus. Through this small opening 19 inches 
of intestine protruded. The w^oman recovered, and the fetal heart-beats 
could be rcadilv auscultated. 

Major accidents in pregnant women are often followed by the happiest 
results. There seems to be no limit to what the pregnant uterus can success- 
fully endure. Tiffany ,^'^" who has collected some statistics on this subject, 
as well as on operations successfully performed during pregnancy, which will 
be considered later, quotes^ the account of a woman of twenty-seven, eight 
months pregnant, who was almost buried under a clay wall. She received 
terrible wounds about the head, 32 sutures being used in this location 

a 545, 1859. ^ 236, 1878. c 125^ xx. 

d Harris, 125, xx. e 50O, 1863, vii., 409. f 644, 1881, vi., 203. 


alone. Subsequently she was confined, easily bore a perfectly normal female 
child, and both did well. Sibois ^ describes the case of a woman weigh- 
ing 190 pounds, wdio fell on her head from the top of a wall from 10 
to 12 feet high. For several hours she exhibited symptoms of fracture of 
the base of the skull, and the case Mas so diagnosed ; fourteen hours after 
the accident she was perfectly conscious and suffered terrible pain about the 
head, neck, and shoulders. Two days later an ovum of about twenty days 
was expelled, and seven months after she was delivered of a healthy boy 
weighing 10| pounds. She had therefore lost after the accident one-half 
of a double conception. 

Verrier'^ has collected the results of traumatism during pregnancy, and 
summarizes 61 cases. Prowzowsky ^ cites the instance of a patient in the 
eighth month of her first pregnancy who was w^ounded by many pieces of 
lead pipe fired from a gun but a few feet distant. Neither the patient nor 
the child suffered materially from the accident, and gestation proceeded ; the 
child died on the fourth day after birth without apparent cause. Milner*^ 
records an instance of remarkable tolerance of injury in a pregnant woman. 
During her six months of pregnancy the patient was accidentally shot through 
the abdominal cavity and lower part of the thorax. The missile penetrated 
the central tendon of the diaphragm and lodged in the lung. The injury was 
limited by localized pneumonia and peritonitis, and the wound was drained 
through the lung by free expectoration. Recovery ensued, the patient giving 
birth to a healthy child sixteen weeks later. Belin*' mentions a stab-wound 
in a pregnant woman from which a consideralde portion of the epiploon pro- 
truded. Sloughing ensued, but the patient made a good recovery, gestation 
not being interrupted. Fancon *" describes the case of a woman who had an 
injury to the knee requiring drainage. She was attacked by erysipelas, 
which spread over the whole body with the exception of the head and neck ; 
yet her pregnancy was uninterrupted and recovery ensued. Fancon also 
speaks of a girl of nineteen, frightened by her lover, who threatened to stab 
her, who jumped from a second-story window. For three days after the 
fall she had a slight bloody flow from the vulva. Although she was six 
months pregnant there was no interruption of the normal course of 

Bancroft" speaks of a Avoman who, l)eing mistaken for a l^urglar, was shot 
by her husband with a 44-caliber bullet. The missile entered the second 
and third ribs an inch from the sternum, passed through the right lung, and 
escaped at the inferior angle of the scapula, al)out three inches below the 
spine ; after leaving her body it went through a pine door. She suffered 
much hemorrhage and shock, but made a fair recovery at the end of four 
weeks, though pregnant with her first child at the seventh month. At full 

a 788, 1887, July 1, 345. b Rev. Med.-chir. d. Mai. d. Femmes, Paris, 1888. x., 529. 
c 812, 1879, iv., 1113. d 533, ixi., 243. e 236, 1878. f Quoted 844, 251. g 545, 1876. 


term she was delivered by foot-presentation of a healthy boy. The mother 
at the time of re])ort was healthy and free from cough, and was nursing her 
babe, which was strong and bright. 

All tlie cases do not have as happy an issue as most of the foregoing ones, 
though in some the results are not so bad as might be expected. A German 
female, thirty-six, while in the sixth month of pregnancy, fell and struck 
her abdomen on a tub. She was delivered of a normal living child, with 
the exception that the helix of the left ear was pushed anteriorlv, and had, 
in its niidtUe, a deep incision, which also traversed the antihelix and the 
tragus, and continued over the cheek toward the nose, where it terminated. 
The external auditory meatus was obliterated. Gurlt speaks of a woman, 
seven months pregnant, who fell from the top of a ladder, subsequently 
losing some blood and water from the vagina. She had also persistent 
pains in the belly, but there was no deterioration of general health. At her 
confinement, which was normal, a strong boy was born, wanting the arm 
below the middle, at which point a white bone protruded. The wound 
healed and the separated arm came away after birth. Wainwright ^ relates 
the instance of a woman of forty, who when six months pregnant was run 
over by railway cars. After a double amputation of the legs she miscarried 
and made a good recovery. Neugel^auer '' reported the history of a case of a 
woman \vho, while near her term of pregnancy, committed suicide by jump- 
ing from a window. She ruptured her uterus, and a dead child with a frac- 
ture of the parietal bone was found in the abdominal cavity. Staples ^ 
speaks of a Swede of twenty-eight, of Minnesota, who was accidentally shot 
by a young man riding by her side in a wagon. The ball entered the 
abdomen two inches above the crest of the right ilium, a little to the rear of 
the anterior superior spinous process, and took a downward and forward 
course. A little shock was felt but no serious symptoms followed. In 
forty hours there was delivery of a dead child with a bullet in its abdomen. 
Labor was normal and the internal recovery complete. Von Chelius, '^^^ 
quoting the younger Naegele, gives a remarkable instance of a young peasant 
of thirty-five, the mother of four children, pregnant with the fifth child, who 
was struck on the belly violently by a blow from a wagon pole. She was 
throAvn down, and felt a tearing pain which caused her to faint. It was 
found that the womb had been ruptured and the child killed, fi)r in several 
days it was delivered in a putrid mass, partly through the natural passage 
and partly through an abscess opening in the abdominal wall. The woman 
made a good recovery. A curious accident of pregnancy '^ is that of a 
woman of thirty-eight, advanced eight months in her nintli pregnancy, wlio 
after eating a heart}' meal was seized by a violent pain in the region of the 
stomach and soon afterward with convulsions, supposed to have been puer- 
peral. She died in a few hours, and at the autopsy it was found that labor 

a 647, 1877, 59. b 782 ; and 261, 1890, 88. c 538, 1876. ^ 218, Oct. 1, 1868. 


had not beiiun, but that the pregnancy had caused a laceration of the spleen, 
from which had escaped four or live pints of blood. Edge'* speaks of a case 
of chorea in pregnane}- in a woman of twenty-seven, not interrupting preg- 
nancy or retarding safe delivery. This had continued for four pregnancies, 
but in the fourth abortion took place. 

Buzzard ^ had a ease of nervous tremor in a woman, following a fall at 
her fourth month of pregnancy, who at term gave birth to a male child that 
was idiotic. Beatty " relates a curious accident to a fetus in utero. The 
woman was in her first confinement and was delivered of a small but healthy 
and strong boy. There Avas a small puncture in the abdominal parietes, 
through which the whole of the intestines protruded and were constricted. 
The opening was so small that he had to enlarge it with a bistoury to replace 
the bowel, which w^as dark and congested ; he sutured the w'oinid with silver 
wire, but the child subsequently died. 

Tiffany '^•'' of Baltimore has collected excellent statistics of operations 
during pregnancy ; and Mann of Buffalo'^ has done the same work, limit- 
ing himself to operations on the pelvic organs, where interference is sup- 
posed to have been particularly contraiudicated in pregnancy. Mann, after 
giving his individual cases, makes the following summary and conclusions : — 

(1) Pregnancy is not a general bar to operations, as has been supposed. 

(2) Union of the denuded surfaces is the rule, and the cicatricial tissue, 
formed during the earlier months of pregnancy, is strong enough to resist 
the shock of labor at term. 

(3) Operations on the vulva are of little danger to mother or child. 

(4) Operations on the vagina are liable to cause severe hemorrhage, but 
otherwise are not dangerous. 

(5) Venereal vegetations or warts are best treated by removal. 

(6) Applications of silver nitrate or astringents may be safely made to the 
vagina. For such application, phenol or iodin should not be used, pure or in 
strong solution. 

(7) Operations on the bladder or urethra are not dangerous or liable to 
be followed by abortion. 

(8) Operations for vesicovaginal fistulte should not be done, as they are 
dangerous, and are liable to be followed by much hemcn'rhage and aliortion. 

(9) Plastic operations may be done in the earlier months of pregnancy 
with fair prospects of a safe and successful issue. 

(10) Small polypi may be treated by torsion or astringents. If cut, 
there is likely to be a subsequent abortion. 

(11) Large polypi removed tow^ard the close of pregnancy will cause 

(12) Carcinoma of the cervix should be removed at once. 

A few^ of the examples on record of Operations during pregnancy of 

a 244, 1889, i., 516. b 476, 1868, ii., 479. c 224, 1879, i., 701. <i 764, 1882. 



special interest, will be given below. Polaillon " speaks of a double ovari- 
otomy on a woman pregnant at three months, with the subsequent birth of a 
living ehild at term. Gordon '^ reports five suecessful ovariotomies during 
pregnancy, in Lebedeif 's clinic. Of these cases, 1 al^orted on the fifth day, 
2 on the fifteenth, and the other 2 continued uninterrupted. He collected 
204 cases with a mortality of only o ])er cent. ; 22 per cent, aborted, and 
69.4 per cent. Avere delivered at full term. Kreutzman "" reports two cases 
in which ovarian tumors were successfully removed from pregnant subjects 
without the interruption of gestation. One of these women, a secundipara, 
had gone two weeks over time, and had a large ovarian cyst, the pedicle 
of which had become twisted, the fluid in the '^yst being sanguineous. Mav '^ 
describes an ovariotomy performed during pregnancy at Tottenham Hospital. 
The woman, aged twenty-two, was i)ale, diminutive in size, and showed an 
enormous abdomen (Fig. 12), which measured 50 inches in circumference at 

the umbilicus and 27 inches from the 
ensiform cartilage to the pubes. At the 
operation, 36 pints of brown fluid Avere 
drawn off. Delivery took jilace twelve 
hours after the operation, the mother re- 
covering, but the child was lost. Gala- 
i)in '^ had a case of ovariotomy performed 
on a woman in the sixth month of preg- 
nancy witliont interruption of ])regnancv ; 
Potter ^ liad a case of douljle ovariotomy 
A\'ith safe deli\ery at term ; and Storry s 
had a similar case. Jacobson^ cites a 
case of vaginal lithotomy in a patient 
six and a half months pregnant, with 
normal delivery at full term. Tifi'any quotes Keelan's' description of a 
woman of thirty-five, in the eighth month of pregnancy, from Avhom he 
removed a stone weigliing 12^ ounces and measuring 2 by 2^ inches, with 
subsequent recovery and continuation of pregnancy. RydygierJ mentions 
a case of obstruction of the intestine durine" the sixth month of o-estation, 
showing symptoms of strangulati(»n for seven days, in which he performed 
abdominal section. Recovery of the woman without abortion ensued. The 
Re\aie de Chirurgie, 1887, contains an account of a woman who suffered 
internal strangulation, on whom celiotomy Avas ]ierformed ; she recoA'ered in 
twenty-fiA'e days, and did not miscarry, Avhich shoAvs that scA'ere injury to the 
intestine with operatiA'c interference does not necessarily iiiterrujit jiregnancy. 
Gilmore,'^ AA^ithout inducing abortion, extirpated the kidney of a negress, aged 

Fig. 12. — Ovariotomy during pregnancy. (Alay, 
British Med. .Tour., Dec. 2, 1893.) 

a 653, 1892. 

d 224, Dec. 2, 1893. 

11476, 1889, i., 628. 

b 261, 1894. 
e 224, 1880. 
i 224, Oct. 15, 1887. 

c Occidental Med. Times, Aug., 1892. 

f 125, 1888. g 476, 1882. 

J 844, 250. k 125, May, 1871. 


thirty-three, for severe and constant pain. Tiffany '* removed the kidney of 
a woman of twenty-seven, five months pregnant, without interruption of tlris 
or subsequent pregnancies. The child was living. He says that Fancon 
cites instances of operation without abortion. 

Ijovort '^ describes an enucleation of the eye in the second month of 
pregnancy. Pilcher'^ cites the instance of a woman of fifty-eight, eight 
months in her fourth pregnancy, whose breast and axilla he removed without 
interruption of pregnancy. Robson,*^ Polaillon, and Coen report similar 

Rein speaks of the removal of an enormous echinococcus cyst of the 
omentum without interruption of pregnancy. Robson® reports a multi- 
locular cyst of the ovary with extensive adhesions of the uterus, removed at 
the tenth week of pregnancy and ovariotomy performed without any inter- 
ruption of the ordinary course of labor. Russell * cites the instance of a 
woman who was successfully tapped at the sixth month of pregnancy. 

McLean" speaks of a successful amputation during pregnancy ; Xap})er, "'^ 
one of the arm ; Xicod, one of the arm ; Russell,'' an amputation through 
the shoulder joint for an injury during pregnancy, with delivery and 
recovery ; and Vesey ' speaks of amputation for compound fracture of the 
arm, labor following ten hours afterward with recovery. KeenJ reports the 
successful performance of a hip-joint amputation for malignant disease of 
the femur during pregnancy. The patient, who was five months advanced 
in prestation, recovered without abortins:. 

Robson reports a case of strangulated hernia in the third month of preg- 
nancy with stercoraceous vomiting. He performed herniotomy in the 
femoral region, and there was a safe delivery at full term. In the second 
month of pregnancy he also rotated an ovarian tumor causing acute symptoms, 
and afterward performed ovariotomy without interfering with pregnancy. 
Mann quotes Munde in speaking of an instance of removal of elephantiasis of 
the vulva without interrupting pregnancy, and says that there are many cases 
of the removal of venereal warts without any interference with gestation. 
Campbell of Georgia operated inadvertently at the second and third month 
in two cases of vesicovaginal fistula in pregnant women. The first case 
showed no interruption of pregnancy, but in the second case the Avoman 
nearly died and the fistula remained unhealed. Engelmann operated on a 
large rectovaginal fistula in the sixth month of pregnancy Avithout any in- 
terruption of pregnancy, which is far from the general result. Cazin and 
Rey both produced abortion by forcible dilatation of the anus for fissure, 
but Gayet used both the fingers and a speculum in a case at five months and 
the woman went to term. By cystotomy Reamy removed a double hair-i)in 

a 533, April 16, 1887. ^> 238, 1887. c 648, 1879. d 2-24, 1889. 

e 224, 1879. f 535, 127, n. s. ii., 430-433. S 582, 1852. 

h476, 1872, ii., 632. i 224, 1878. J 533, March 26, 1892. 


from a woman })ret>naiit six and a half months, without interruption, and 
accordiuir to Mann auain, McChntock extracted stones from the bladder b>^ 
the urethra in the fourth month of pregnancy, and Phillips did the same in 
the seventh month. Hendenl)erti and Packard •' report the renKjval of a 
tumor weighing 8| pounds from a pregnant uterus without interrupting ges- 

The f )llowing extract frou) the T'niversity Medical Magazine of Phila- 
delithia illustrates the after-effects of abdominal hysteropaxy on sub- 
sequent pregnancies : — 

" Fraipont i^Amidfcs fie hi Societe Medico-Chirurgk'ale de Liege, 1894) re- 
ports four cases where pregnancy and labor were practically normal, though 
the uterus of each patient had been fixed to the abdominal walls. In two- 
of the cases the hysteropexy had been performed over five years before the 
pregnancy occurred, and, although the bands of adhesion between the fundus 
and the parietes must have become very tough after so long a period, no 
special difficulty was encountered. In tAvo of the eases the forceps was used, 
but not on account of uterine inertia ; the fetal head was voluminous, and in 
one of the two cases internal rotation was delayed. The placenta was always 
expelled easily, and no serious postpartum hemorrhage occurred. Fraipc^nt 
observed the progress of pregnancy in several of these cases. The uterus 
does not increase specially in its })Osterior part, but quite uniformly, so that, 
as might be expected, the fundus gradually detaches itself from the abdom- 
inal wall. Even if the adhesions were not broken down they would of ne- 
cessity be so stretched as to be useless for their original purpose after deliv- 
ery. Bands of adhesion could not share in the process of involution. As,, 
how'ever, the uterus undergoes perfect involution, it is restored to its original 
condition before the onset of the disease which rendered hysteropexy neces- 

The coexistence of an extensive tumor of the uterus with pregnancy 
does not necessarily mean that the product of conception will be 1)lighted. 
Brocliiu ^ speaks of a case in which pregnancy was com])licated with fibroma of 
the uterus, the accouchement being natural at term. Byrne ^ mentions a case 
of pregnancy complicated with a large uterine fibroid. Delivery w^as effected 
at full term, and although there was considerable hemorrhage the mother 
recovered. Ingleby '^ describes a case of filjrous tumor of the uterus termi- 
nating fatally, but not until three weeks after delivery. Lusk*^ mentions a 
case of pregnancy with fibrocystic tumor of the uterus occluding the cervix. 
At the appearance of symptoms of eclampsia version was performed and 
delivery effected, followed by postpartum hemorrhage. The mother died 
from peritonitis and collapse, but the stillborn child was resuscitated. Rob- 
erts ^ reports a case of pregnancy associated with a large fibrocellular polypus. 

a 590, 1890, xxv., 306. b 363, xlviii., 1178. ^ 310, 1877, 170. 

d 318, li., 75. e 125, 1876, ix., 94. f 476, 1867, i., 333. 



of the uterus. A liviug; cliild was delivered at the seveuth uiontli, ecrase- 
meut was performed, and the mother recovered. 

Von Quast '"^ speaks of a librorayoma removed five days after lal)()r. 
Gervis '' reports the removal of a large polypus of the uterus on the fifth day 
after confinement. Davis '^ describes the spontaneous expulsion of a large 
polypus two days after the delivery of a fine, healthy, male child. Deason^ 
mentions a case of anomalous tumor of the uterus during pregnancy which 
was expelled after the birth of the child; and Daly also*^ speaks of a 
tumor expelled from the uterus after delivery. Cathell ^ speaks of a case 
of pregnancy complicated with both uterine fibroids and measles. Other 

Fig. 13. — Large fibroid blocking the pelvis (Spiegelberg). 

cases of a similar nature to the foregoing are too numerous to mention. 
Figure 13, taken from Spiegelberg, shows a large fibroid blocking the pelvis 
of a pregnant woman. 

There are several peculiar accidents and anomalies not previously men- 
tioned which deserve a place here, viz., those of the membranes surround- 
ing the fetus. Brown " speaks of protrusion of the membranes from the 
vulva several weeks before confinement. Da vies '^ relates an instance in 
which there was a copious watery discharge during pregnancy not followed 

a Kansas City Merl. Index, 1888. 
•1593, 1859, xvi., 663. 
g 616, 1872, XV., 246. 

b 778, xi., 4. 

e 778, 1887, xxviii., 170. 

c 124, 1843, vi.. 519. 
f 775, 1886, 157. 
li 537, 1834. 


by labor. There is a case mentioned " in wliich an accident and an inoppor- 
tune dose of ergot at tlie fifth month of pregnancy were foHowed by ruj)ture 
of the amniotic sac, and subseciuently a constant flow of Avatery fluid con- 
tinued for the remaining three months of pregnancy. The fetus died at the 
time, and was born in an advanced state of jjutrefaction, by version, three 
months after the accident. The mother died five months after of carcinoma 
of tlie uterus. Montgomery '' reports the instance of a woman who menstru- 
ated last on May 22, I80O, and quickened on September 2Gtli, and continued 
well until the lltli of November. At this time, as she was retiring, she 
became conscious that there was a watery discharge from the vagina, which 
proved to be liquor anmii. Her health was good. The discharge continued, 
her size increased, and the motions of the child continued active. On the 
18th of January a full-sized eight months' child was born. It had an incessant, 
wailing, low cry, always of evil auguiy in new-born infants. The child died 
shortly after. The daily discharge was about 5 ounces, and had lasted sixty- 
eight days, making 21 pints in all. The same accident of rupture of the 
membranes long before labor happened to the patient's mother. 

Bardt ^ speaks of labor twenty-three days after the flow of the Avaters ; 
and Cobleigh '^ one of seventeen davs : Bradlev*^ relates the historv of a 
case of rupture of the membranes six weeks before delivery. Rains * cites 
an instance in which gestation continued three months after rupture of the 
membranes, the labor-pains lasting thirty-six hours. Griffiths^-'' speaks of 
rupture of the amniotic sac at about the sixth month of pregnancy with no 
untoward interruption of the completion of gestation and with delivery of a 
living child. There is another observation ° of an accouchement terminating 
successfully twenty-three days after the loss of the amniotic fluid. Camp- 
bell '^ mentions delivery of a living child twelve days after rupture of the 
membranes. Chesney ^ relates the history of a double collection of waters. 
WoodJ reports a case in which there was expulsion of a bag of waters be- 
fore the rupture of the membranes. Bailly, Chestnut, Bjering, Cowger, 
Duncan, and others also record premature rupture of the membranes with- 
out interruption of pregnancy. 

Harris "^ gives an instance of the membranes being expelled from the 
uterus a few days before delivery at the full term. Chatard, Jr.,' mentions 
extrusion of the fetal meml)ranes at the seventh month of pregnancy Avhile 
the patient was taking a long afternoon walk, their subsequent retraction, and 
normal lal)or at term. Thurston ™ tells of a case in which Nature had ap- 
parently efl'ected the separation of the placenta without alarming hemorrhage, 
the case being one of placenta praevia, terminating favorably by natural pro- 

a 366, 1844-45, v., 163. b 308, 1857. c 463, xiii., 33. '^ 545, 1877, xxxvii. 

e 224, 1871, ii., 612. f 131, 1875, iii., 253. g 461, 1807, xiii., 33. h 2I8, Ixxxvii., 196. 
i 481, 1868-69, ii., 346. J Month. .Tour. Med. Sci., Loud, and Edinb., ix., 853. 

k778, vii., 47. 1 125, 1886. "1224, 1884. 


cesses. Playfiiir'* speaks of the detachment of the uterine decidua without 
the interruption of pre^i^nanoy. 

Guerrant'^ gives a unique example of normal l)irth at full term in which 
the placenta was found in the vagina, but not a vestige of the membranes was 
noticed. The patient had experienced nothing unusual until within three 
months of expected confinement, since which time there had been a daily loss 
of water from the uterus. She recovered and was doing her work. There 
was no })ossibility that this was a case of retained secundines. 

Anomalies of the Umbilical Cord. — Absence of the membranes has its 
counterpart in the deficiency of the umbilical cord, so frequently noticed in 
old reports. The Ephemerides, Osiander, Stark's Archives,^"*^ Thieljault, 
van der Wiel, Chatton, and Schurig ''-^ all speak of it, and it has been noticed 
since. Danthez '^ speaks of the development of a fetus in spite of the absence 
of an umbilical cord. Stute '^ reports an observation of total absence of the 
umbilical cord, with placental insertion near the cervix of the uterus. 

There is mentioned *^ a bifid funis. The Ephemerides ^ and van der 
AViel speak of a duplex funis. Xolde ^ reports a cord 38 inches long ; and 
AVerner'' cites the instance of a funis 51 inches long. There are modern in- 
stances in which the funis has been bifid or du})lex, and there is also a case 
reported in which there were two cords in a twin pregnancy, each of them 
measuring five feet in length. The Lancet ' gives the account of a most pe- 
culjar pregnancy consisting of a placenta alone, the fetus wanting. AVhat 
this " placenta " was will always be a matter of conjecture. 

Occasionally death of the fetus is caused by the formation of knots in 
the cord, shutting otf the fetal circulation ; Gery, Grieve, ^Nlastin, Passot, 
Piogey, AVoets, and others report instances of this nature. Newman J reports 
a curious case of twins, in which the cord of one child was encircled by a 
knot on the cord of the other. Among others, Latimer ^ and Motte ' report 
instances of the accidental tying of the bowel with the funis, causing an arti- 
ficial anus. 

The diverse causes of abortion are too numerous to attempt giving 
them all, but some are so curious and anomalous that they deserve men- 
tion. p]pidemics of abortion are spoken of liy Fickius, Fischer, and the 
Ephemerides. Exposure to cold is spoken of as a cause,"" and the same is 
alluded to l)y the Ephemerides ; ^ while another case is given as due to 
exposure while nude.° There are several cases among the older writers in 
which odors are said to have produced aljortion, but as analogues are 
not to be found in modern literature, unless the odor is very poisonous or 
pungent, we can give them but little credence. The Ephemerides gives the 

a 610, 1879-80. b 609, 1879-80, ii., 480. c 368, 1842. d 363, xxix., 498. 

e Solingen,742 f io4, dec. i., ann. i., obs. 39. g 160, vii., 197. ^ 160, vii., 523. 

i 476, 1842-43. J 318, 1858, iv., 8-10. k 545, xlvi., 242. 1 242, liv., 494. 

m 108, dec. i., ann. ii., 121. n 104, dec. ii., ann. i., obs. 116. o 664, T. iv. 


odor of urine as provocative of abortion ; Sulzberger,^ Meyer, ^^'^ and Alber- 
tus "'^ all mention odors ; and Vcsti gives as a plausible cause ^ the odor of 
carbonic vapor. The Ephemerides ° mentions singultus as a cause of abor- 
tion. Mauriceau,'''^ Pelargus, and \^ikntini '"^^ mention coughing. Hippo- 
crates mentions '^ the case of a Avouian who induced abortion bv calling exces- 
sively loud to some one. Fabricius Hildanus ''''^ speaks of abortion following 
a kick in the region of the coccyx. GuUmannus ® speaks of an abortion 
which he attributes to the v\-oman's constant neglect to answer the calls of 
nature, the rectum being at all times in a state of irritation from her negli- 
gence. Hawley ^ mentions abortion at the fourth or fifth month due to the 
absorption of spirits of turjx'ntine. Solingen"^ speaks of al)ortion produced 
by sneezing. Osiander ^-^-^ cites an instance in which a woman suddenly arose, 
and in doing so jolted herself so severely that she produced abortion. Hip- 
pocrates speaks of extreme hunger as a cause of abortion. Treuner s speaks 
of great anger and wrath in a woman disturbing her to the extent of producing 

The causes that are obsen'ed every day, such as tight lacing, excessive 
venerv^, fright, and emotions, are too well known to be discussed here. 

There has been reported a recent case of aliortion following a viper-bite, 
and analogues may be found in the writings of Severinus and Oedman, who 
mention" viper-bites as the cause ; but there are so many associate conditions 
accompanying a snake-bite, such as fright, treatment, etc., any one of which 
could be a cause in itself, that this is by no means a reliable explanation. In- 
formation from India on this subject would be quite valuable. 

The Ephemerides speak of bloodless abortion, and there have been modern 
instances in which the hemorrhage has been hardly noticeable. 

Abortion in a twin pregnancy does not necessarily mean the abortion or 
death of both the products of conception. Chapman ^ speaks of the case of the 
expulsion of a blighted fetus at the seventh month, the living child remaining 
to the full term, and being safely delivered, the placenta following. Crisj)' 
says of a case of labor that the head of the child was obstructed l)y a round 
botlv, the nature of which he was for some time unable to determine. He 
managed to push the obstructing l)ody up and delivered a living, full-term 
child ; this "vvas soon followed by a blighted fetus, which was 1 1 inches long, 
weighed 12 ounces, with a placenta attached weighing 6| ounces. It is quite 
common for a blighted fetus to be retained and expelled at term with a living 
child, its tAvin. 

Bacon J speaks of twin pregnancy, with tlie death of one fetus at the fourth 
month and the other delivered at term. Beall ^ reports the conception ( >f twins, 

a Diss, deabortu, c. 6. '^ Diss, de abortn, 21. t- 476. dec. ii., aim. 2, ob.*;. 62. 

<i416, opp. iv., 600. e 105, 1730, ii.. 374. <" 231, 1858-59, xiv , 469. 

g 160, B. iv., 527. 1> 550, ix., 194. > 779. xviii., 272. 

J Clinique, Chicago, vii., 403. k 703, xviii., 122. 


with one fetus expelled and the other retained ; Beauchanip cites a similar 
instance. Bothwell ^ describes a twin labor at term, in which one child was 
living and the other dead at the fifth month and macerated. Belt '^ reports an 
analogous case. Jameson ° gives the historv of an extraordinary case of 
twins in which one (dead) child was retained in the womb for forty-nine 
weeks, the other having been born alive at the expiration of nine months. 
Hamilt(jn "^ describes a case of twins in which one fetus died from the elfects 
of an injur}' between the fourth and fifth months and the second arrived at 
full period. Moore ^ cites an instance in which one of the fetuses perished 
about the third month, but was not expelled until the seventh, and the other 
was carried to full term. Wilson ^ speaks of a secondary or blighted fetus of 
the third month with fatty degeneration of the membranes retained and 
expelled with its living twin at the eighth month of uterogestation. 

There was a case at Riga in 1839 of a robust girl who conceived in Feb- 
ruary, and in consequence her menses ceased. In June she aborted, but, to 
her dismay, soon afterward the symptoms of advanced pregnancy appeared, and 
in November a full-grown child, doubtless the result of the same impregna- 
tion as the fetus, was expelled at the fourth month. In 1S60 Schuh reported 
an instance bef<jre the ^'ienna Faculty of Medicine in wliicli a fetus was dis- 
charged at the third month of pregnancy and the other twin retained until 
full term. The abortion was attended with much metrorrhagia, and ten 
weeks afterward the movements of the other child could be plainly felt and 
pregnancy continued its course uninterrupted. Bates ^ mentions a twin preg- 
nancy in which an abortion took place at the second month and was followed 
by a natural birth at full term. Hawkins •* gives a case of miscarriage, followed 
by a natural birth at full term ; and Xewnham ' cites a similar instance in wliich 
there was a miscai'riagc at the seventh month and a birth at full term. 

Worms in the Uterus. — Haines •> s})eaks of a most curious case — that of 
a woman who had had a miscarriage three days previous ; she suffered intense 
pain and a fetid discharge. A number of maggots were seen in the vagina, 
and the next day a mass about the size of an orange came away from the 
uterus, riddled with holes, and which contained a number of dead maggots, 
killed Ijy the carl)olic acid injection given soon after the miscarriage. The 
fact seems inexplicable, but after their expulsion the symptoms innnediately 
ameliorated. This case recalls a somewhat similar one given by the older 
writers, in which a fetus was eaten by a worm.'^ Analogous are those cases 
spoken of by Bidel ' of lumbricoides found in the uterus ; by Hole,™ in which 
maggots were found in the vagina and uterus ; and Simpson," in which the 

a 224, 1889, ii., 717. b 104, 1855, xxix. c 310, 1842-43, xxii., 15. 

d312, 1843. e 519, 1870, iv., 208. f Month. Jour. Med., Lond., 1855. 

g 771, 1874. h 772, 1881. i 776, 1823. 

J 476, 1889, i., 16. ^ 104^ dec. iii., ann. 7 and 8, obs. 32. 

1 235, 1856, li., 549. m 543, 1889-90. n 600, 1878-79, 129. 



abortion was caused by worms in the womb — if the associate symptoms were 

\\ e can find fabulous 2)arallcls to all of these in some of the older writings. 
Pare'' mentions I^ycosthenes' account of a woman in Cracovia in 1494 who 
bore a dead child which had attached to its back a live serpent, wliich had 
gnawed it to death. He gives an illustration (Fig. 14) showing the serpent 
in situ. He also quotes the ease of a woman who conceived by a mariner, 
and who, after nine months, was delivered by a midwife of a shapeless mass, 
followed by an animal with a long neck, blazing eyes, and clawed feet. Bal- 
lantyne^ says that in the writings of Hippocrates there is in the work on 
" Diseases " i^Ikpi ^ouo-wv), which is not usually regarded as genuine, a some- 

Fig. 14. — Serpent in a fetus (after Pare). 

what curious statement with regard to worms in the fetus. It is affirmed 
that flat Avorms develop in the unborn infant, and the reason given is that the 
feces are expelled so soon after birth that there would not be sufficient time 
during extrauterine life for the formation of creatures of such a size. The 
same remark applies to round worms. The proof of these statements is to be 
found in the fact that many infants expel both these varieties of parasites with 
the first stool. It is difficidt to know what to make of these opinions ; for, 
with the exception of certain cases in some of the seventeenth and eighteenth 
century writers, there are no records in medicine of the occurrence of vermes 
in the infant at birth. It is possible that other things, such as dried pieces 
A mucus, may have been erroneously regarded as worms. 

a 618, 733. b 759, Oct., 1895. 


General Considerations. — In discussing obstetric anomalies we shall 
first consider those strange instances in which stages of parturition are uncon- 
scious and for some curious reason the pains of labor absent. Some women 
are anatomically constituted in a manner favorable to child-birth, and pass 
through the experience in a comparatively easy manner ; but to the great 
majority the throes of labor are anticipated with extreme dread, particularly 
by the victims of the present fashion of tight lacing. 

It seems strange that a physiologic process like parturition should be 
attended by so much pain and difficulty. Savages in their primitive and 
natural state seem to have difficulty in many cases, and even animals are not 
free from it. We read of the ancient wild Irish women breaking the 
pubic bones of their female children shortly after birth, and by some means 
preventing union subsequently, in order that these might have less trouble in 
child-birth — as it were, a modified and early form of symphysiotomy. In 
consequence of this custom the females of this race, to quote an old English 
authority, had a " waddling, lamish gesture in their going." These old writers 
said that for the same reason the women in some parts of Italy broke the 
coccyxes of their female children. This report is veiy likely not veracious, 
because this bone spontaneously repairs itself so quickly and easily. Rodet 
and Engelmann/"'^ in their most extensive and interesting papers on the modes 
of accouchement among the primitive peoples, substantiate the fear, pain, and 
difficulty with which labor is attended, even in the lowest grades of society. 

In view of the usual occurrence of pain and difficulty with labor, it seems 
natural that exceptions to the general rule should in all ages have attracted 
the attention of medical men, and that literature should be replete with siicli 
instances. Pechlin^'^'- and Maas'* record instances of painless births. The 
Ephemerides records a birth as having occurred during asphyxia, and 
also one during an epileptic attack. Storck also speaks of birth during 
unconsciousness in an epileptic attack ; and Haen ^^^ and others ^ describe 
cases occurring during the coma attending apoplectic attacks. King*^ 
reports the histories of two married women, fond mothers and anticipat- 
ing the event, who gave birth to children, apparently unconsciously. In 

a 601, 315. b 708, 1719, ii., 610. c 546, 1847, xvi., 234. 

8 113 


the first case, the appearance of the woman verified the assertion ; in the 
second, a transient suspension of the menstrual influence accounted for it. 
After some months epilepsy developed in this case. Crawford * speaks of a 
Mrs. D., who i>ave birtli to twins in her first confinement at full term, and 
who two years after aborted at three months. In December, 1868, a year 
after the abortion, she was delivered of a healtliy, living fetus of about five or 
six months' urowth in the followino; manner : AVhile at stool, she discovered 
something of a shining, bluisli appearance protruding through the external 
labia, but she also found that when she lay down the tumor disappeared. 
This tumor proved to be the cliild, wliich had been expelled from the uterus 
four days before, with the waters and membranes intact, l)ut Avhich had not 
been recognized ; it had passed through the os without pain or symptoms, and 
had remained alive in the vagina over four days, from whence it was delivered, 
presenting by the foot. 

The state of intoxication seems by record of several cases to render 
birth painless and unconscious, as well as serving as a means of anesthesia in 
the preanesthetic days. 

The feasibility of practising hypnotism in child-birth has been dis- 
cussed, and Fanton '■ reports 12 cases of parturition under the hypnotic influ- 
ence. He says that none of the sulijects suftered any pain or were aware of 
the birth," and oifers the suggestion that to facilitate the state of hypnosis it 
should be commenced before strong uterine contractions have occurred. 

Instances of parturition or delivery during sleep, lethargies, trances, 
and similar conditions are by no means luicommon. Heister "^ speaks of l)irth 
during a convulsive somnolence, and Osiander "^ of a case during sleep. ]Mont- 
gomery relates the case of a lady, the mother of several children, who on one 
occasion was luiconsciously delivered in sleep. Case ^ relates the instance of a 
French woman residing in the town of Hopedale, who, though near confine- 
ment, attributed her symptoms to over-fatigue on the previous day. When 
summoned, the doctor found that she had severe lumbar pains, and that the os 
was dilated to the size of a half-dollar. At ten o'clock he suggested that 
everyone retire, and directed that if anything of import occurred he should be 
called. About 4 a. m. the husband of the girl, in great fright, summoned 
the physician, saying : " Monsieur le Medecin, il y a quehpie chose entre les 
jambes de ma femme," and, to Dr. Case's surprise, he found the head of a 
cliild wholly expelled during a profound sleep of the mother. In twenty 
minutes the secundines followed. The patient, who was only twenty years 
old, said that she had dreamt that something was Ihe matter with her, and 
awoke with a fright, at wliich instant, most probably, the head was expelled. 
She was atterward confined with the usual labor-pains. 

Palfrey ^speaks of a woman, pregnant at term, who fell into a sleep about 

a 579, 1868-69, n. s., iv., 305-8. b 168, 1890. c 402, xii., 103. 

d 135, ii., 74. e 124, Jan., 1868. f 476, 1864, i., 36. 


eleven o'clock, and dreamed that she was in g;reat pain and in labor, and 
that sometime after a fine child was crawling; over the bed. After sleeping 
for about four hours she awoke and noticed a discharge from the vagina. Her 
husband started for a light, l)ut before he obtained it a child was born by a 
head-presentation. In a few minutes the labor-pains returned and the feet of 
a second child presented, and the child was expelled in three pains, followed 
in ten minutes by the placenta. Here is an authentic case in which labor pro- 
gressed to the second stage during sleep. 

Weill ^ describes the case of a woman of twent}'-three who gave birth to a 
robust boy on the IGth of June, 1877, and suckled him eleven months. This 
birth lasted one hour. She became pregnant again and was delivered under 
the following circumstances : She had been walking on the evening of Sep- 
tember 5th and returned home about eleven o'clock to sleep. About 3 A. m. 
she awoke, feeling the necessity of passing urine. Slie arose and seated 
herself for the purpose. She at once uttered a cry and called her husband, 
telling him that a child was born and entretiting him to send for a physician. 
Weill saw the woman in about ten minutes and she was in the same position, 
so he ordered her to be carried to bed. On examining the urinal he found a 
female child weighing 10 pounds. He tied the cord and cared for the chikl. 
The woman exhibited little hemorrhage and made a complete recovery. She 
had apparently sle}>t soundly through the uterine contractions until the final 
strong pain, which awoke her, and which she imagined was a call for urina- 

Samelson ^ says that in 1S44 he was sent for in Zabelsdorf, some 30 miles 
from Berlin, to attend Hannah Rhode in a case of labor. She had passed 
easily through eight parturitions. At about ten o'clock in the morning, after 
a partially unconscious night, there was a sudden gush of blood and water 
from the vagina ; she screamed and lapsed into an unconscious condition. 
At 10.35 the face presented, soon followed by the body, after which came a 
great flow of blood, welling out in several waves. The child was a male, 
middle-sized, and was some little time in making himself heard. Only by 
degrees did the woman's consciousness return. She felt weaiy and inclined to 
sleep, but soon after she awoke and was much surprised to know what had 
happened. She had seven or eight pains in all. Schultze ° speaks of a woman 
who, arriving at the period for delivery, went into an extraordinary state of 
somnolence, and in this condition on the third day bore a living male child. 

Berthier in 1859 observed a case of melancholia with delirium which 
continued through pregnancy. The woman was a})parently unconscious of 
her condition and was delivered without pain. Cripps*^ mentions a case in 
which there was absence of pain in parturition. Depaul ^ mentions a woman 
who fell in a public street and was delivered of a living child during a 

a Quoted, 224, 1881, ii., 871. ^ 224, 186."), ii.. Nov. 

c 476, 1845, i. d 475, 1841-42, ii., 367. e j, d. sages-femmes. Par., 1882, 9. 


syncope which lasted four hours. Epley* reports painless labor in a patient 
with paraph'uia. Falniestoek ^' speaks of the case of a woman Avho was deliv- 
ered of a son while in a state of artificial somnambulism, without pain to herself 
or injury to the child. Among others mentioning painless or unconscious 
labor are Behrens (during profound sleep), Eger, Tempel, Panis, Agnoia, 
Blanekmeister, AA'hitehill, Gillette, Mattel, Murray, Lemoine, and Moglichkeit. 

Rapid Parturition Without Usual Symptoms. — Births unattended by 
symptoms that are the usual precursors of labor often lead to speedy deliveries 
in awk\vard places. According to AVilloughby,^^^ in Darby, February 9, 1 667, 
a poor fool, Mary Baker, while wandering in an open, windy, and cold place, 
was delivered by the sole assistance of Nature, Eve's midwife, and freed of 
her afterbirth. The poor idiot had leaned against a wall, and dropped the 
child on the cold boards, where it lay for more than a quarter of an hour 
with its funis separated fi'om the placenta. She was only discovered by the 
cries of the infant. In " Carpenter's Physiology " '^ is described a remarkable 
case of instinct in an idiotic girl in Paris, who had been seduced by some 
miscreant ; the girl had gnawed the funis in t^vo, in the same manner as is 
practised by the lower animals. From her mental imbecility it can hardly be 
imagined that she had any idea of the object of this separation, and it nuist 
have been instinct that impelled her to do it. Sermon^^'^ says the wife of 
Thomas James was delivered of a lusty child while in a wood by herself. 
She put the child in an apron with some oak leaves, marched stoutly to 
her husband's uncle's house a half mile distant, and after two hours' rest 
went on her journey one mile farther to her own house ; despite all her exer- 
tions she returned the next day to thank her uncle for the two hours' accom- 
modation. There is related ^ the history of a case of a woman who was 
delivered of a child on a mountain dtiring a hurricane, mIio took off her 
gown and wrapped the child up in it, together with the afterbirth, and 
walked two miles to her cottage, the funis being unruptured. 

Harvey relates a case, which he learned from the President of INIunster, 
Ireland, of a woman with child who followed her husband, a soldier in the 
army, in daily march. They were forced to a halt by reason of a river, and 
the woman, feeling the pains of labor approaching, retired to a tliicket, and 
there alone brought forth twins. She carried them to the river, washed 
them herself, did them up in a cloth, tied them to her back, and that very 
day marched, barefooted, 12 miles with the soldiers, and was none the worse 
for her experience. The next day the Deputy of Ireland and the President 
of ]\Iunster, affected by the story, to repeat the words of Har\'ey, " did both 
vouchsafe to be godfathers of the infants." 

Willoughby "^-^ relates the account of a woman who, having a cramp while 
in bed with her sister, went to an outhouse, as if to stool, and was there 
delivered of a child. She quickly returned to bed, her going and her return 

a 597^ xxxvii., 233. b 218, xxxv., 194, c 1st edition, 219. '1279, 1857. 



not being noticed by her sleeping sister. She buried the child, " and after- 
ward confessed her wickedness, and was executed in the Stafford Gaol, March 
31, 1670." A similar instance is related by the same author of a servant in 
Darby in 1(347. Nobody suspected her, and when delivered she was lyiug in 
the same room with her mistress. She arose without awakening anyone, 
and took the recently delivered child to a remote place, and hid it at the bottom 
of a feather tub, covering it with feathers ; she returned without any suspi- 
cion on the part of her mistress. It so happened that it was the habit of the 
Darl)v soldiers to peep in at night where they saw a light, to ascertain if 
evervthing was all right, and they thus discovered her secret doings, which 
led to her trial at the next sessions at Darby. 

Wagner^ relates the history of a case of great medicolegal interest. An 
unmarried servant, who was pregnant, persisted in denying it, and took every 
pains to conceal it. She slept in a room with two other maids, and, on ex- 
amination, she stated that on the night in question she got up toward morn- 
ing, thinking to relieve her bowels. For this j^urpose she secured a wooden 
tub in the room, and as siie was sitting down the child passed rapidly into 
the empty vessel. It was only then that she became aware of the nature of 
her pains. She did not examine the child closely, but was certain it neither 
moved nor cried. The funis was no doubt torn, and she made an attempt to 
tie it. Regarding the event as a miscarriage, she took up the tub with its 
contents and carried it to a sand pit al)()ut ?>0 paces distant, and threw the 
child in a hole in the sand that she found already made. She covered it up 
with sand and packed it firndy so that the dogs could not get it. She re- 
turned to her bedroom, first calling up the man-servant at the stable. She 
awakened her fellow-servants, and feeling tired sat down on a stool. Seeing 
the blood on the floor, they asked her if she had made way with the child. 
She said : '' Do you take me for an old sow ? " But, having their suspicions 
aroused, they traced the blood spots to the sand pit. Fetching a spade, they 
dug up the child, which was about one foot below the surface. On the access 
of air, followino; the removal of the sand and turf, the child began to cry, and 
was immediately taken up and carried to its m<3ther, who washed it and laid 
it on her bed and soon gave it the breast. The child was healthy with the 
exception of a club-foot, and must have been under ground at least fifteen 
minutes and no air could have reached it. It seems likely that the child was 
born asphyxiated and was buried in this state, and only began to assume in- 
dependent vitality when for the second time exposed to the air. This curious 
case was verified to English correspondents by Dr. AVagner, and is of unques- 
tionable authority ; it became the subject of a thorough criminal investiga- 
tion in Germany. 

During the funeral procession of ]\Iarshal Mac^SIahon in Paris an enor- 
mous crowd was assembled to see the cortege pass, and in this crowd was a 

a 554, Jan. 17, 1838. 


woman almost at the time of dclivcrv ; the jostlino- which she received in her 
endeavors to obtain a pUice of vantage was sutticient to excite contraction, 
and, in an upright position, she gave birth to a fetus, which fell at her feet. 
The cro\vtl pushed back and made way for the ambulance officials, and mother 
and child were carried t)lf, the mother apparently experiencing little embari'ass- 
ment. Quoted by Taylor,"^''" Anderson speaks of a woman accused of child 
murder, who walked a distance of 28 miles on a single day with her two- 
days-old child on her btick. 

There is also a case of a female servant ^ named Jane May, who was fre- 
(piently charged by her mistress with pregnancy but persistently denied it. 
On October 26th she was sent to market v.'ith some poultry. Iveturning 
home, she asked the boy who drove her to stop and allow her to get out. 
She went into a recess in a hedge. In five minutes she was seen to leave the 
hedge and follow the cart, walking home, a distance of a mile and a half. The 
following day she went to work as usual, and would not have been found out 
had not a boy, hearing feeble cries from the recess of the hedge, sunuiioned a 
passer-by, l)ut too late to save the child. At her trial she said she did not 
see her babe breathe nor cry, and she thought by the sudden birth that it 
must have been a still-born child. 

Shoiit ^ says that one day, while crossing the esplanade at Villaire, between 
seven and eight o'clock in the morning, he perceived three Hindoo women with 
large baskets of cakes of " bratties " on their heads, coming from a village 
about four miles distant. Suddenly one of the women stood still for a minute, 
stooped, and to his surprise dropped a fully developed male child to the ground. 
One of her companions ran into the town, about 100 yards distant, for a knife 
to (hvide the cord. A few of the female passers-by formed a screen about the 
mother with their clothes, and the cord was divided. The after-birth came 
away, and the Avoman was removed to the town. It was afterward discovered 
that she was the mother of two children, was twenty-eight years old, had not 
the slightest sign of approaching labor, and was not aware of parturition 
until she actually felt the child between her thighs. 

Smith of Madras, in 1862, says he was hastily summoned to see an English 
lady who had borne a child without the slightest warning. He found the 
child, which had been born ten minutes, lying close to the mother's body, with 
the funis uncut. The native female maid, at the lady's orders, had left the 
child untouched, lifting the bed-clothes to give it air. The lady said that she 
arose at 5.30 feeling well, and during the forenoon had walked down a long 
flight of steps across a walk to a small summer-house within the enclosure of 
her grounds. Feeling a little tired, she had lain down on her bed, and soon 
experienced a slight discomfort, and was under the impression that something 
solid and warm was lying in contact with her person. She directed the ser- 
vant to look below the bed-clothes, and then a female child was discovered. 

a 548, 1867, i., 500. b 773, 1863. 


Her other labors had extended over six hours, and were preceded by all 
the signs distinctive of childbirth, which fact attaches additional interest to 
the case. The ultimate fate of the child is not mentioned. Smith quotes 
Wilson, who said he was called to see a woman who was delivered without 
pain while walking; alwut the house. He found the child on the floor with 
its umbilical cord torn across. 

Laugston ^ mentions the case of a woman, twenty-three, who, between 4 
and 5 A. m., felt griping pains in the abdomen. Knowing her condition, 
she suspected labor, and determined to go to a friend's house where she could 
be confined in safety. She had a distance of about 600 yards to go, and 
when she was about half way she was delivered in an upright position of a 
child, which fell on the pavement and ru[)tured its funis in the fall. Shortly 
after, the placenta was expelled, and she proceeded on her journey, carrying the 
child in her arms. At 5.50 the physician saw the woman in bod, looking well 
and free from pain, but complaining of being cold. The child, which was her 
first, was healthy, well nourished, and normal, with the exception of a slight 
ecchvmosis of the ])arietal l)t>ne on the left side. The funis was lacerated 
transversely four inches from the uml)ilicus. Both mother and child progressed 
favorably. Doubtless the intense cold had so contracted the blood-vessels as 
to prevent fatal hemorrhage to mother and child. This case has a legal bear- 
ing in the supposition that the child had been killed in the fall. 

There is reported'' the case of a woman in Wales, who, while walking with 
her husband, was suddenly seized with pains, and would have been delivered 
bv the wayside but for the timely help of ^ladame Patti, the celebrated diva, 
who was driving by, and who took the woman in her carriage to her palatial 
residence close by. It was to be christened in a few days with an appropriate 
name in remembrance of the occasion. Coleman *^^ met an instance in a mar- 
ried woman, wdio without the slightest Avarning was delivered of a child 
while standing near a window in her bedroom. The child fell to the floor 
and ruptured the cord about one inch from the umbilicus, but with speedy 
attention the happiest results were attained. Twitchell "^ has an example in 
the case of a young woman of seventeen, who was suddenly delivered of a child 
while ironing some clothes. The cord in this case was also ruptured, but the 
child sustained no injuiy. Taylor ^'^^ quotes the description of a child who 
died from an injury to the head caused by dropping from the mother at an 
unexpected time, while she was in the erect position ; he also speaks of a 
parallel case on record. 

Unusual Places of Birth. — Besides those mentioned, the other awkward 
positions in which a child may be born are so numerous and diversified that 
mention of only a few can be made here. Colton^ tells of a painless labor in 
an Irish girl of twenty-three, who felt a desire to urinate, and while seated on 

a 476, 1864, i., 637. ^ 548, 1887, ii., 157. c 476, 1864, ii., 377. 

d476, 1864, 476. e 52O, 1879, i., 68. 


tlie chamber dropped a child. Slie never felt a lahor-pain^ and twelve days after- 
ward rode 20 miles over a rough road to go to her baby's funeral. Leonhard " 
describes the case of a mother of thirty-seven, who had borne six children alive, 
who was pregnant for the tenth time, and who had miscalcidated her pregnancv. 
During pregnancy she had an attack of small-jxtx and suffered all through preg- 
nancy with constipation. She had taken a laxative, and when returning to 
bed from stool was surprised to find herself attached to the stool by a band. 
The child in the vessel began to cry and was separated from the woman, who 
returned to bed and suddenly died one-half hour later. The mother was 
entirely unconscious of the delivery. AVestphal '' mentions a deliveiy in a 

Brown "^ speaks of a woman of twenty-six who had a call of nature while 
in bed, and while sitting up she gave birth to a line, full-grown child, which, 
falling on the floor, ruptured the funis. She took her child, lay down with 
it for some time, and feeling easier, hailed a cab, drove to a hospital with 
the child in her arms, and wanted to walk upstairs. She was put to bed and 
delivered of the placenta, there being but little hemorrhage from the cord ; 
both she and her child made speedy recoveries. Thebault '^ reports an instance 
of deliveiy in the erect position, with rupture of the funis at the placenta. 
There was recently a rumor, probably a newspaper faljrication, that a woman 
while at stool in a railway car gave birth to a child which was found alive 
on the track afterward. 

There is a curious instance on record in which a child was born in a hip- 
bath and narrowly escaped drowning.*" The mother was a European woman 
aged forty, who had borne two children, the last nine years before. She was 
supposed to have dropsy of the abdomen, and among other treatments was the 
use of a speculum and caustic applications for inflammation of the womb. 
The escape of wateiy fluid for two days was considered evidence of the rup- 
ture of an ovarian cyst. At the end of tw^o days, severe pains set in, and a 
M^arm hip-l)ath and an opiate were ordered. AVhile in the bath she l)ore a 
fully-matured, living, male child, to the great surprise of herself and her 
friends. The child might have been drowned had not assistance been close at 

Birth by the Rectum. — In some cases in which there is some obstacle 
to the delivery of a child by the natural passages, the eflorts of nature to 
expel the product of conception lead to an anomalous exit. There are some 
details of births by the rectum mentioned in the .last century by Reta and 
others. Payne ^ cites the instance of a woman of thirty-three, in labor thirty- 
six hours, in whom there Avas a congenital absence of the vaginal orifice. The 
finger, gliding along the perineum, arrived at a distended anus, just inside of 
wdiich was felt a fetal head. He anesthetized the patient and delivered the 

a 554, No. 24, 1837. b 807, xxi., 329. c 224, April 3, 1863. 

d 809, 1875, ii., 230. e 548, 1862, ii., 396. f 491, 1886, 542. 


«liild with forceps, and without perineal rupture. There was httle hemor- 
rhage, and the placenta was removed with slight difficulty. Five months latel', 
Payne fotmd an unaltered condition of the perineum and vicinity ; there was 
absence of the vaginal orifice, and, on introducing the finger along the anterior 
wall of the rectum, a fistula was found, communicating with the vagina ; 
above this point the arrangement and the situation of the parts were normal. 
The woman had given birth to three still-b(irn children, and always menstru- 
ated easily. Coitus always seemed satisfactory, and no suspicion existed in 
the patient's mind, and had never been suggested to her, of her abnormality. 

Harrison* saw a fetus delivered by the anus after rupture of the uterus; 
the membranes came away by the same route. In this case the neck of 
the uterus was cartilaginous and firmly adherent to the adjacent parts. In 
seven davs after the accouchement the woman had completely regained her 
health. Vallisneri "^*' reports the instance of a woman who possessed two 
uteruses, one communicating with the vagina, the other with the rectum. She 
had permitted rectal copulation and had become impregnated in this manner. 
Louis, the celebrated French surgeon, created a furore by a i)amphlet entitled 
^'De partium externarura generationi inservientium in nudieribus naturali 
vitiosa et morbosa dispositione, etc.," for which he was punished by the Sor- 
bonne, but absolved by the Po])e. He descrilx'd a young lady who had no 
vaginal opening, but who regularly menstruated by the rectum. She allowed 
her lover to have connection with her in the only possible way, by the rectum, 
which, however, sufficed for impregnation, and at term she bore by the rec- 
tum a well-formed child. Hunter'' speaks of a case of pregnancy in a woman 
with a double vagina, who was delivered at the seventh month by the rectum. 
Mekeln*' and Andrews*^ give instances of parturition through the anus. 
Morisani'' describes a case of extrauterine pregnancy with tubal rupture and 
discharge into the culdesac, in which there was delivery l)y the rectum. After 
an attack of severe abdominal pain, followed by hemorrhage, the woman ex- 
perienced an urgent desire to empty the rectum. The fetal movements ceased, 
and a recurrence of these symptoms led the patient to go to stool, at wdiich 
she passed blood and a seromucoid fluid. She attempted manually to remove 
the offending substances from the rectum, and in consequence grasped the leg 
of a fetus. She was removed to a hospital, where a fetus nine inches long was 
removed from the rectum. The rectal opening gradually cicatrized, the sac 
became obliterated, and the woman left the hospital well. 

Birth Through Perineal Perforation. — Occasionally there is perineal 
perforation during labor, with birth of the child through the opening. Brown ^ 
mentions a case of rupture of the perineum with birth of a child between the 
vaginal opening and the anus. Cassidy s reports a case of child-birth through 
the perineum. A successful operation was performed fifteen days after the 

a Reportorio Med.-Chirurg. di Torino, 1825. b Trans. N. Y. Obs. Soc, 1879, i., 348. 
c 372, 1833, 184. d 526, 1839. e 838, 1889. f 476, 1860, i., 496. g 545, ix., 192. 


accident. Dupuytnni^ speaks of the passage of an infant through a central 
opening of the perineum. Capiiron, (irravis, and Lebrun all report aeeouehe- 
menl through a perineal perforation, without alteration in the sphincter ani or 
the fourchet. In his " Diseases of Women " Simpson speaks of a fistula left 
by the passage of an infant through the perineum. Wilson, Toloshinoff, Stolz, 
Argles, Demarquay, Harley, Hernu, ^larts'u, Lamb, ]\Iorere, Pollock, and 
others rect)rd the birth of children througii perineal perforations. 

Birth Through the Abdominal Wall. — Ilollerius^-^ gives a veiy pecu- 
liar instance in which the alxlominal Avails gave way from the pressure exerted 
by the fetus, and the uterus ruptured, allowing the child to be extracted by 
the hand from the umbilicus ; the mother made a speedy recovery. In such 
cases delivery is usually by means of operative interference (which will be 
spoken of later), but rarely, as here, spontaneously. Fanjuharson '' and 111" 
both mention rupture of the abdominal parietes during labor. 

There have been cases reported in which the recto-vaginal septum has been 
ruptured, as well as the perineum and the sphincter ani, giving all the appear- 
ance of a birth by the anus. 

There is an account*^ of a female who had a tumor projecting between the 
vagina and rectum, which was incised througii the intestine, and proved to be 
a dead child. Saviard"^"' reported what he considered a rather unique case, 
in wliich tlic uterus was ruptured by external violence, the fetus being thrown 
forA\ard into the abdomen and afterward extracted from an umbilical abscess. 

Birth of the Fetus Enclosed in the Membranes. — Harvey'*'^^ says 
that an infant can rest in its menil)ranes several hours after birth without loss 
of life. Schurig"^^ eventrated a pregnant bitch and her puppies lived in their 
membranes half an hour. Wrisberg cites three observations of infants born 
closed in their membranes ; one lived seven minutes ; the other two nine 
minutes ; all breathed when the membranes were cut and air admitted. 
Willoughby^^^ recorded the history of a case which attracted much comment at 
the time. It was the birth of twins enclosed in their secundines. The sac was 
opened and, together with the afterbirth, was laid over some hot coals ; there 
was, how^ever, a happy issue, the children recovering and living. Since Wil- 
loughby's time several cases of similar interest have been noticed, one in a 
woman *^ of forty, who had l)een married sixteen years, and who had had several 
pregnancies in her early married life and a recent abortion. Her last preg- 
nancy lasted about twenty-eight or twenty-nine weeks, and terminated, after 
a short labor, by the expulsion of the ovum entire.. The membranes had not 
been ruptured, and still enclosed the fetus and the liquor amnii. On break- 
ing them, the fetus was seen floating on the waters, aliv^e, and, though very 
diminutive, was perfectly formed. It continued to live, and a day afterward 
took the breast and began to cry feebly. At six weeks it weighed 2 jiounds 
2 ounces, and at ten months, 12 pounds, but was still ver\^ weak and ill-nour- 

a 368, 1832, iii., 684. b 524, 1789. c 600, 1878-9, xli., 43. d 470, 1722. e 492, 1828. 

"DRY BIRTHS." 123 

ished. Evans '^ has an instance of a fetus expelled enveloped in its membranes 
entire and unruptured. The membranes were opaque and preternatural ly 
thickened, and were opened with a pair of scissors ; strenuous efforts \vere 
made to save the child, but to no purpose. The mother, after a short con- 
valescence, made a oood recovery. Forman ^ reports an instance of unruptured 
membranes at birth, the delivery following a single pain, in a woman of 
twentv-two, pregnant for a second time. Woodson '^ speaks of a case of 
twins, one of which was l)(»rn enveloped in its secundines. 

Van Bibber '^ was called in great haste to see a patient in labor. He 
reached the house in about fifteen minutes, and was told by the midwife, a 
woman of experience, that she had summoned him because of the expulsion 
from the womb of something the like of which she had never seen before. 
She thought it must have been some variety of false conception, and had 
wrap})ed it up in some flannel. It proved to be a fetus enclosed in its sac, 
with the })lacenta, all having been expelled together and intact. He told the 
nurse to rupture the membranes, and the child, which had l)een in the unrup- 
tured sac for over twenty minutes, began to cry. The infant lived for over a 
month, but eventually died of bronchitis. 

Covvger® reports labor at the end of the seventh month without rupture 
of the fetal sac. Macknus ^ and Rootes ^ speak of expulsion of the entire 
ovum at the full period of gestation. Roe mentions a case of parturition with 
uiu-iiptured membrane. Slusser'^ describes the delivery of a full-grown fetus 
without rui)ture of the meml)rane. 

*' Dry Births." — The reverse of the foregoing are those cases in which, 
by reason of the deficiency of the waters, the birth is dry. Numerous causes 
can be stated for such occurrences, and the reader is referred elsewhere for 
them, the subject being an old one. The Ephemerides speaks of it, and 
Rudolph *'^^ discusses its occurrence exhaustively and tells of the difficulties 
of such a labor. Burrall ' mentions a case of lal)or without apparent litpior 
amnii, delivery being effected by the forceps. Strong J records an unusual 
obstetric case in which there was prolongation of the pregnancy, with a large 
child, and entire absence of liquor amnii. The case was also complicated 
with interstitial and subserous fibroids and a contracted pelvis, combined with 
a p(tsterior position of the occiput and nonrotation of the head. Lente'^ 
mentions a case of labor without liquor amnii ; and Townsend^ records de- 
livery without any sanguineous discharge. Cosentino '" mentions a case of the 
absence of liquor amnii associated with a fetal monstrosity. 

Delivery After Death of the Mother. — Cnrious indeed are those 

a 252, 1852-3, i., 146. b 538, 1896, Feb. 1, 160. c 124, 1860, 569. 

d 510, 1879, iv., 303. e 538, xxv., 84. f 476, 1846, i., 186. 

g 476, 1845, ii., 474. h West. Lancet, Cincin., xii., 501. ^ 124, cxL, 446. 

J 218, ex., 30. k 124. clxi., 125. 1 124, 1854, 342. 

m Arch, di Ostet. e Ginec., p. 41, Feb.-March, 1894. 


anomalous eases in wliieli the (Idivny is eifected spontaneously after the death 
of the mother, or when, by manipulation, the eliild is saved after the maternal 
decease. Wegelin '"* gives the account of a hirth in which version was per- 
formed after death and the child successfully «Klivered. Bartholinus, Wolff, 
Schenck, Horstius, Hagendorn, Fabricius Hildanus, Valerius, Rolfinck, Cor- 
narius, Boener, and other old(M' writers cite cases of this kind. Pinard '' 
gives a most wonderful ease. The patient was a woman of thirty-eight who 
had experienced five normal labors. On October 27th she fancied 
she had labor pains and went to the Lariboisiere Maternite, where, after a 
careful examination, three fetal poles were elicited, and she was told, to her 
surprise, of the probability of triplets. At 6 P. M., November 13th, the 
pains of labor commenced. Three hours later she was having great dyspnea 
with each pain. This soon assumed a fatal aspect and the midwife attemjited 
to resuscitate the patient l)y artificial respiration, but failed in her efforts, and 
then she turned her attention to the fetuses, and, one by one, she extracted them 
in the short space of five minutes ; the last one was born twelve minutes after 
the mother's death. They all lived (the first two being females), and they 
weighed from 4 J to 6|^ pounds. 

Considerable attention has been directed to the advisability of accelerated 
and forced labor in the dying, in order that the child may be saved. Belluzzi 
has presented several papers on tliis subject. Csurgay of Budapest mentions 
saving the child by forced labor in the death agonies of the mother. Devil- 
liers '^ considers this question from both the obstetric and medicolegal points of 
view. Hyneaux mentions forcible accouchement practised on both the dead 
and the dying. Rogowicz advocates artificial delivery by the natural channel 
in place of Cesarian section in cases of pending or recent death, and Thevenot ^ 
discussed this question at length at the International Medico-Legal Congress in 
1878. Duer® presented the question of postmortem delivery in this country. 

Kelly ^ reports the histoiy of a woman of forty who died in her eighth 
pregnancy, and who Avas delivered of a female child by version and artificial 
means. Artificial respiration was successfully practised on the cliild, although 
fifteen minutes had elapsed from the death of the mother to its extraction. 
Driver ^ relates the history of a woman of thirty-five, who died in the eighth 
month of gestation, and who was delivered postmortem by the vagina, man- 
ual means only being used. The operator was about to perfi)rm Cesarean 
section when he heard the noise of the membranes rupturing. Thornton'' 
reports the extraction of a living child by version after the death of the 
mother. Aveling* has compiled extensive statistics on all varieties of post- 
mortem deliveries, collecting 44 cases of spontaneous expulsion of the fetus 
after death of the mother. 

a 160, B. i., 4 St., 11. 7. •' 140, .Jan., 1889. c 789, 1862, 581. 

d 140, 1878. e io5_ xii., 1 and 374. f 125, viii., 558. 

g 579, 1860, 494. ^ 272, 1858. i 778, 1873, xiv., 240. 


Aveling states that in 1820 the Council of Cologne sanctioned the placing 
of a gag in the mouth of a dead pregnant woman, thereby hoping to prevent 
suffocation of the infant, and there are numerous such laws on record, althoutrh 
most of them pertain to the performance of Cesarean section immediately after 

Reiss records the death of a woman who w^as hastily buried wliile her 
husband was away, and on his return he ordered exhumation of her body, 
and on opening the coffin a child's cry was heard. The infant had evidently 
been born postmortem. It lived long afterward under the name of " Fils 
de la terre." AVilloughby ^-^ mentions the curious instance in which rum- 
bling was heard from the coffin of a woman during her hasty burial. One of 
her neighbors returned to the grave, applied her ear to the ground, and was 
sure she heard a sighing noise. A soldier with her affirmed her tale, and 
together they went to a clergyman and a justice, begging that the grave be 
opened. When the coffin was opened it was found that a child had been born, 
which had descended to her knees. In Derbyshire, to this day, may be seen 
on the parish register: "April ye 20, 1650, was buried Emme, the wdfe of 
Thomas Toplace, who was found delivered of a child after she had lain two 
hours in the grave." 

Johannes ^latthaeus relates the case of a buried woman, and that some 
time afterward a noise was heard in the tomb. The coffin was immediately 
opened, and a living female child rolled to the feet of the corpse. Hagen- 
dorn mentions the birth of a living child some hours after the death of the 
mother. Dethardingius mentions a healthy child l)orn one-half hour after the 
mother's death. In the Gentleman's Magazine ^ there is a record of an in- 
stance, in 1759, in which a midwife, after the death of a woman whom she 
had failed to deliver, imagined that she saw a movement under the shroud, 
and found a child between its mother's legs. It died soon after. Valerius 
Maximus says that while the body of the mother of Gorgia Epirotas was 
being carried to the grave, a loud noise was heard to come from the coffin, 
and on examination a live child was found between the thighs, — whence arose 
the proverb : " Gorgiam prius ad funus datum, quam natum fuisse." 

Other cases of postmortem delivery are less successful, the deliveiy being 
delayed too late fjr the child to be viable. The first of Aveling's cases was 
that of a pregnant woman who was hanged by a Spanish Inquisitor in 1551. 
While still hanging, four hours later, two children were said to have 
dropped from her ^vomb. The second case was of a woman of Madrid, who 
after death was shut in a sepulcher. Some months after, when the tomb was 
opened, a dead infant was found by the side of the corpse. Rolfinkius tells of 
a woman who died during parturition, and her body being placed in a cellar, 
five days later a dead boy and girl were found on the bier. Bartholinus is 
accredited with the following : Three midwives failing to deliver a woman, 

a XXIX., 390. 


she died, and forty-eight hours after death her abdomen swelled to such an 
extent as to burst her grave-clothes, and a male child, dead, was seen issuing 
from the vagina. Bonet-^'' tells of a woman, who died in Brussels in 1633, 
wlio, undelivered, expired in convulsions on Thursday. On Friday abdomi- 
nal movements in the corpse were seen, and on Sunday a dead child was 
found hanging between the thighs. According to Aveling, Herman of 
Berne reports the instance of a young lady whose body was far advanced in 
putrefaction, from which was expelled an unbroken ovum containing twins. 
Even the placenta showed signs of decomposition. Naumann relates the 
birth of a child on the second day after the death of the mother. Kichter of 
Weissenfels, in 1861, reported the case of a woman who died in convulsions, 
and sixty hours after death an eight months' fetus came away. Stapedius 
writes to a friend of a fetus being found dead between the thighs of a woman 
who expired suddenly of an acute disease. Schenk mentions that of a woman, 
dying at 5 P. m., a child having two front teeth was born at 3 A. ir. 
Veslingius tells of a woman dying of epilepsy on June 6, 1630, from whose 
body, two days later, issued a child. Wolfius relates the case of a wouum 
dying in labor in 1677. Abdominal movements being seen six hours after 
death. Cesarean section was suggested, but its performance was delayed, and 
eighteen hours after a child was spontaneously born. Hover of ]Mulhausen 
tells of a child with its mouth open and tongue protruding, which was born 
while the mother was on the way to the grave. Bedford of Sydney, accord- 
ing to Aveling, relates the stoiy of a case in which mal])ractice was suspected 
on a woman of thirty-seven, who died while pregnant with her seventh child. 
The body was exhumed, and a transverse rupture of the womb six inches long 
above the cervix was found, and the body of a dead male cliild lay between 
the thighs. In 1862, Lanigan tells of a woman who was laid out for funeral 
obsequies, and on removal of the covers for burial a child was found in bed 
with her. Swayne is credited with the description of the death of a woman 
whom a midwife failed to deliver. Desiring an inquest, the coroner had the 
body exhumed, when, on opening the coffin, a well-developed male infant was 
found parallel to and lying on the lower limbs, the cord and ])laeenta being 
entirely unattached from the mother. 

Some time after her decease Harvey found between the thighs of a dead 
woman a dead infant which had been expelled ])ostmortem. Mayer ^ relates 
the history of a case of a woman of forty-five who felt the movement of her 
child for the fourth time in the middle of Xovember. In the following 
INIarch she had hemoptysis, and serious symptoms of inflannnation in the right 
lung following, led to her apparent death on the 31st of the month. For two 
days previous to her death she had failed to perceive the fetal movements. 
She was kept on her back in a room, covered up and undisturbed, for thirty- 
six hours, the members of the family occasionally visiting her to sprinlvle holy 

a 801, 1854. 


water on her face. There was no remembrance of cadaveric distortion of the 
features or any odor. When the undertakers were drawing the shroud on 
they noticed a half-round, bright-red, smooth-looking body between the geni- 
tals which they mistook for a prolapsed uterus. Early on April 2d, a few 
hours before interment, tlie men thought to examine the swelling they had 
seen the day before. A second look showed it to be a dead female cliild, now- 
lying between the tliighs and connected with the mother by the umbilical cord. 
The interment was stopped, and Mayer was called to examine the body, but 
with negative results, though the signs of death were not plainly visible for a 
woman dead fifty-eight hours. By its development the body of the fetus con- 
firmed the mother's account of a pregnancy of twenty-one weeks. Mayer 
satisfies himself at least that the mother was in a trance at the time of delivery 
and died soon afterward. 

Moritz ^ gives the instance of a woman dying in pregnancy, undelivered, 
who happened to be disinterred several days after burial. The body was in 
an advanced state of decomposition, and a fetus was found in the coffin. It 
was supposed that the pressure of gas in the mother's body had forced the 
fetus from the uterus. Ostmann *• speaks of a woman married five months, 
who was suddenly seized with rigors, headache, and vomiting. For a week 
she continued to do her daily work, and in addition was ill-treated by her 
husband. She died suddenly without having any abdominal pain or any 
symptoms indicative of abortion. The body was examined twenty-four hours 
after death and was seen to be dark, discolored, and the abdomen chstended. 
There was no sanguineous discharge from the genitals, but at the time of rais- 
ing the body to place it in the coffin, a fetus, with the umbilical cord, 
escaped from the vagina. There seemed to have been a ruj)id putrefaction in 
this case, generating enough pressure of gas to expel the fetus as well as the 
uterus from the body. This at least is the view taken by Hoffman and others 
in the solution of these strange cases. 

Antepartum Crying of the Child. — There are on record fabulous 
cases of children crying in the uterus during pregnancy, and all sorts of unbe- 
lievable stories have been constructed from these reported occurrences. Quite 
possible, however, and worthy of belief are the cases in which the child has 
been heard to cry during the progress of parturition — tliat is, during delivery. 
Jonston '^ speaks of infants crying in the womb, and attempts a scientific 
explanation of the fact. He also quotes the following lines in reference to this 
subject : — 

" Mirundum foetus uiaterna clausus in alvo 

Dicitur insuetos ore dedisse sonos. 
Causa subest ; doluit se angusta sede teiieri, 

Et cupiit magnae cernere moliis opus. 
Aut quia quferendi studio vis fessa parentum 

Aucupii aptas innuit esse manus. " 

a Quoted by 124, cvi., 117. ^ 807, Band 28, 228. c 447, 464. 


The Ephemerides * gives examples of the child hiccoughing in the uterus. 
Cases of crying before delivery, some in the vagina, some just before the com- 
})lete expulsion of the head from the os uteri, are very numerous in the older 
writers ; and it is (juite possible that on auscultation of the pregnant abdomen 
fetal sounds may have been exaggerated into cries. Bartholinus,'^ Borellus, ° 
Boyle, Buchner, Paullini, Mezger, Biolanus, Lentillus, ]Marcellus Donatus, ^ 
and Wolffs all speak of children ciying before delivery ; and Mazinus^ relates 
the instance of a puppy wliose feeble cries could be heard before expulsion 
from the l)iteh. Osiander fully discusses the subject of infants ciying during 

^ McLean s describes a case in which he positively states that a child cried 
//lustily in utero during application of the forceps. He compared the sound as 
though from a voice in the cellar. This child was in the uterus, not in the 
vagina, and continued the cr>'ing during the whole of the five minutes occupied 
l)y delivery. 

Cesarean Section. — Altliough the legendary histor\' of Cesarean section 
is (jiiite copious, it is very seklom that we find authentic records in the 
Avritings of the older medical observers. The works of Hippocrates, Aretaeus, 
Galen, Celsus, and Aetius contain nothing relative to records of successfid 
Cesarean sections. However, Pliny says that Scipio Africanus was the first 
and Manlius the second of the Romans who owed their lives to the operation 
of Cesarean section ; in his seventh book he says that Jidius Ctesar was born 
in this way, the fact giving origin to his name. Others deny this and say that 
his name came from the thick head of hair which he possessed. It is a fre- 
quent subject in old Roman sculpture, and there are many delineations of the 
birth of Bacchus by Cesarean section from the corpse of Semele. Greek 
mythology tells us of the birth of Bacchus in the following manner : After 
Zeus burnt the house of Semele, daughter of Cadmus, he sent Hermes in great 
haste with directions to take from the burnt body of the mother the fruit of 
seven months. This child, as Ave know, was Bacchus. ^Tlsculapius, accord- 
ing to the legend of the Romans, had been excised from the belly of his dead 
mother, Corinis, who was already on the funeral pile, by liis benefactor, Apollo ; 
and from this legend all products of Cesarean sections were regarded as sacred 
to Apollo, and were thought to have been endowed with sagacity and braveiy. 

Old records tell us that one of the kings of Xavarre was delivered in this 
way, and we also have records of the birth of the celebrated Doge, Andreas 
Doria, by this method. Jane Seymour was supposed to have been delivered 
of Edward VI. by Cesarean section, the father, after the consultation of the 
physicians was announced to him, replying : " Save the child by all means, 
for I shall be able to get mothers enough." Robert II. of Scotland was sup- 

a 104, dec. ii., ami. v., ohs. 194, and obs. 15. b 190, cent, i., hist. 18. 

c Cent, iii., obs. 72. d 306, L. vi., cap. ii., 620. 

e Lect. memor., T. ii., 647, 666, 983. f 514, T. iii., 8. g 125, xxii., 166. 


posed to have been delivered in this way after the death of his mother, Mar- 
gery Bruce, who was killed by being thrown from a horse. Shakespere's 
immortal citation of Macduff, " who was from his mother's womb untimely 
ripped," must have been such a case, possibly crudely done, perchance by cattle- 
horn. Pope Gregory XIV. was said to have been taken from his mother's 
belly after her death. The Philosophical Transactions,*^-'' in the last century, 
contain accounts of Cesarean section performed by an ignorant butcher and 
also bv a midwife ; and there are many records of the celebrated case per- 
formed by Jacob Xiifer, a cattle gelder, at the beginning of the sixteenth 

By the advent of antisepsis and the improvements of Porro and others, 
Cesarean section has come to be a quite frequent event, and a record of the 
successful cases would hardly be considered a matter of extraordinary interest, 
and would be out of the province of this work, but a citation of anomalous 
cases will be given. Baldwin^ reports a case of Cesarean section on a typical 
rachitic dwarf of twenty-four, who weighed 100 pounds and was only 47f 
inches tall. It was the ninth American case, according to the calculation 
of Harris, only the third successful one, and the first successful one in 
Ohio. The woman had a uniformly contracted pelvis whose anteroposterior 
diameter was about 1^ inches. The hygienic surroundings for the operation 
were not of the best, as the woman lived in a cellar. Tait's method of per- 
forming the operation was determined upon and successfully performed. 
Convalescence was prompt, and in three weeks the case was dismissed. The 
child was a female of 7 J j)oimds which inherited the deformities of its mother. 
It thrived for nine and a half months, when it died of angina Ludovici. 
Figure lo represents the mother and child. 

Harris ^-^ gives an account of an operation upon a rachitic dwarf who 
was impregnated by a large man, a baby weighing 14 pounds and measuring 
20 inches being delivered by the knife. St. Braun^' gives the account of a 
Porro-Cesarean operation in the case of a racliitic dwarf 3 feet 10 inches 
tall, in which both the mother and child recovered. Munde*^ speaks of twins 
being delivered by Cesarean section. Franklin'^ gives the instance of a 
woman delivered at full term of a living child by this means, in whom was 
also found a dead fetus. It lay behind the stump of the amputated cervix, 
in the culdesac of Douglas. The patient died of hemorrhage. 

Croston" reports a case of Cesarean section on a primipara of twenty-four 
at full term, with the delivery of a double female monster weighing 12|^ 
pounds. This monster consisted of two females of about the same size, united 
from the sternal notch to the navel, having one cord and one placenta. It was 
stillborn. The diagnosis was made before o]>eration by vaginal examination. 
In a communication to Croston, Harris remarked that this was the first suc- 

a 533, Aug. 9, 1890, 138. b 657, 1888 ; quoted by 124, 1890. 

c 218, 1876, ci., 747. ^ 224, 1894. e 218, Dec. 21, 1893. 




cessful Cesarean section for double monstrous conception in America, and added 
that in 1881 Collins and Lcidy pcrformecl the same operation without success. 
Instances of repeated Cesarean section were quite numerous, and the pride 
of the ojK'rators noteworthy, Ixiorc the uterus was removed at the first opera- 
tion, as is now oc-ncrally done. Bac(]ue ^ reports two sections in the same 
woman, and Bcrtrnudi speaks of a case in which the operation was success- 
fully executed many times in the same woman. Rosenberg '^ reports three 
eases repeated successfully 1>v Le<»})old of Dresden. Skutsch reports a case in 

Fig. 15. — Cesarean operation on a dwarf (Ilaldwin) 

which it was twice performed on a woman with a raciiitic ])elvis, and who 
the second time was prciiuant witli twins ; the children and mother recovered. 
Zweifel ^ cites an instance in which two Cesarean sections were performed on a 
patient, both of the children delivered being in vigorous health. Stolz '' relates 
a similar case. Beck '^ gives an account of a Cesarean operation twice on the 
same woman ; in the first the child ]ierished, but in the second it survived. 
Merinar ^ cites an instance of a woman thrice opened. Parravini ^ gives a 

a 463, xi., 572. ^ 125, 1891. c ogi, 1889, No. 13. d 368, 1885, iii., 182 

« 593, 1849-50, vi., 355. f 264, 1856, xi., 172. g 360, 1860, 273. 


similar instance. Charlton'* gives an account of the performance carried out 
successfully four times in the same woman ; Chisholm ^ mentions a case in 
which it was twice performed. Michaelis of Kiel ^ gives an instance in which 
he performed the same operation on a woman four times, with successful issues 
to both mother and children, despite the presence of peritonitis the last time. 
He had operated in 1826, 1830, 1832, and 1836. Coe^ and Gueniot^ both 
mention cases in which Cesarean section had been twice performed with success- 
ful terminations as regards both mothers and children. Rosenberg *' tabulates 
a number of similar cases from medical literature. 

Cases of Cesarean section by the patient herself are most curious, 
but may be readily believed if there is any truth in the reports of the opera- 
tion being done in savage tribes. Felkin ^ gives an account of a successful 
case performed in his presence, with presentation of the lives of both mother 
and child, by a native African in Kahura, Uganda Country (Fig. 16). The 

Fig. 16. — Cesarean operation iu Uganda. 

Fig. 17.— Suture of abdominal walls 
after Cesarean section in Africa. 

Fig. 18. — Knife used in performing Cesarean section iu Africa. 

young girl was operated on in the crudest manner, the hemorrhage being 
checked by a hot iron. The sutures were made by means of seven thin, hot iron 
spikes, resembling acupressure-needles, closing the peritoneum and skin (Fig. 
17). The wound healed in eleven days, and the mother made a complete re- 
covery. Thomas Cowley ^ describes the case of a negro woman who, being 
unable to bear the pains of labor any longer, took a sharp knife and made a deep 
incision in her l:>elly — deep enough to wound the buttocks of her child, and 
extracted the child, placenta and all. A negro horse-doctor was called, who 
sewed the wound up in a manner similar to the way dead bodies are closed at 
the present time. 

a 318, 1837, xlvii., 417. - 318, 1808, iv., 178. c 628, Heft vii., viii., 1836. 

d New York Polyclinic, Aug. 15, 1894. e 789, July 5, 1894. 

f 125, xxiv., No. 10, 1891. g 318, April, 1884. ^ Lend. Med. Jour., 1785, vi., 366. 


Barker * gives the instance of a woman who, on being abused by her hus- 
band after a previous tedious hibor, resolved to free herself of the child, and 
slyly made an incision five inches long on the left side of the abdomen with a 
weaver's knife. When Barker arrived the patient was literally drenched 
with blood and to all appearance dead. He extracted a dead child from 
the abdomen and bandaged the mother, who lived only forty hours. In his 
discourses on Tropical Diseases Moseley speaks of a young negress in Jamaica 
who opened her uterus and extracted therefrom a child which lived six daj's ; 
the woman recovered. Barker relates another case ^ in Rensselaer County, 
N. Y., in which the incision was made with the razor, the Avoman likewise 
recovering. There is an interesting account ° of a poor woman at Prischtina, 
near the Servian frontier, who, suffering greatly from the pains of labor, 
resolved to open her abdomen and uterus. She summoned a neighbor to sew 
up the incision after she had extracted the child, and at the time of report, 
several months later, both the mother and child were doing Avell. 

Madigan '^ cites the case of a woman of thirty-four, in her seventh confine- 
ment, who, while temporarily insane, laid open her abdomen with a razor, in- 
cised tlie uterus, and brought out a male child. The abdominal wound was five 
inches long, and extended from one inch above the umbilicus straight down- 
ward. There was little or no bleeding and the uterus was firmly contracted. 
She did not see a physician for three hours. The child was found dead and, 
with the placenta, was lying by her side. The neighbors were so frightened 
by the awful sight that they ran away, or possibly the child might have been 
saved by ligature of the funis. Not until the arrival of the clergyman was 
anything done, and death ultimately ensued. 

A most wonderful case of endurance of pain and heroism was one occurring 
in Italy,*^ which attracted much European comment at the time. A young 
woman, illegitimately pregnant, at full term, on March 28th, at dawn, opened 
her own abdomen on the left side with a common knife such as is generally 
used in kitchens. The wound measured five inches, and was directed obliquely 
outward and downward. She opened the uterus in the same direction, and 
endeavored to extract the fetus. To expedite the extraction, she drew out an 
arm and amputated it, and finding the extraction still difficult, she cut off the 
head and completely emptied the womb, including the placenta. She bound 
a tight bandage around her body and hid the fetus in a straw mattress. She 
then dressed herself and attended to her domestic duties. She afterward 
mounted a cart and went into the city of Viterbo, where she showed her sis- 
ter a cloth bathed in blood as menstrual proof that 'she was not pregnant. 
On returning home, having walked five hours, she was seized with an attack 
of vomiting and fainted. The parents called Drs. Serpieri and Baliva, who 
relate the case. Thirteen hours had elapsed from the infliction of the wound, 

a 597, 1830-1, i., 381. b 599^ ii.^ 40. c wien. med. Wochenschrift, 1880, No. 13. 
d 476, 1884, i., 146. e 359^ May 2, 1886. 


througli which the bulk of tlie intestines had been protruding for the past six 
hours. The abdomen was irrigated, the toilet made, and after the eighteenth 
day the process of healing was well progressed, and the woman made a 
recovery after her plucky efforts to hide her shame. 

Cases like the foregoing excite no more interest than those on record in 
which an abdominal section has been accidental, as, for instance, by cattle- 
hornvS, and the fetus Ixu'u through the wound. Zuboldie '"^ speaks of a case 
in which a fetus was born from the w<Hind made by a bull's horn in the 
mother's abdomen. Deneux-^^ describes a case in which the wound made }>y 
the horn was not sufficiently large to permit the child's escape, but it was sub- 
sequently brought through the opening. Pigne ^ speaks of a woman of thirty- 
eight, who in the eighth month of her sixth jiregnancy was gored by a bull, 
the horn effecting a transverse wound 27 inches long, running from one an- 
terior spine to the other. The woman was found cold and insensible and 

Fig. 19. — Aei-oiicliciueut liy ;i bull (after an ungiaviiig dated 1047). 

with an imperceptible pulse. The small intestines were lying between the 
thighs and covered with coagulated blood. In the })rocess of cleansing, a 
male child was expelled spontaneously through a rent in the uterus. The 
woman was treated with the usual precautions and was conscious at midday. 
In a month she was up. She lived tsventy years without any inconvenience 
except that due to a slight hernia on the left side. The child died at the end 
of a fortnight. 

In a very exhaustive article Harris of Phila(lel])hia ^ has collected nearly 
all the remaining cases on record, and brief extracts from some of them will 
be given below. In Zaandam, Holland, 1647, a former's wife was tossed by 
a furious bull. Her abdomen was ripped open, and the child and membranes 
escaped. The child suffered no injuries except a bruised upper lip and lived 
nine mouths. The mother died within forty hours of her injuries. Figure 

a 297, ii., n. 43. 

b 162, July, 1836. 

c 125, 1887, XX., 673. 


10, taken from an engravino: dated 1()47, represents an aecouchement by a mad 
bull, possibly the same case. In Dillenberg, Germany, in 1779, a multipara 
was gored by an ox at her sixth mouth of pregnancy ; the horn entered the 
right epigastric region, three inches from the linea alba, and perforated the 
uterus. The right arm of the fetus protruded ; the wound was enlarged and 
the fetus and placenta delivered. Thatcher '^ speaks of a woman who was 
gored by a cow in King's Park, and both mother and child were safely deliv- 
ered and survived. 

In the Parish of Zecoytia, Spain, in 1785, Marie Gratien was gored by an 
ox in the superior portion of her epigastrium, making a wound eight inches 
long which wounded the uterus in the same direction. Dr. Antonio di 
Zubeldia and Don Martin Monaco were called to take charge of the case. 
While they were preparing to effect delivery by tiie vagina, the woman, in an 
attack of singultus, ruptured the line of laceration and expelled the fetus, 
dead. On the twenty-first day the patient was doing well. The wound 
closed at the end of the sixteenth week. The woman subsequently enjoyed 
excellent health and, although she had a small ventral hernia, bore and 
nursed two children. 

Marsh ^ cites the instance of a woman of forty-two, the mother of eight chil- 
dren, who when eight months pregnant was horned by a cow. Her clothes 
were not torn, but she felt that the child had slipped out, and she caught it 
in her dress. She w^as seen by some neighbors twelve yards from the place 
of accident, and was assisted to her house. The bowels protruded and the 
cliild was separated from the funis. A physician saw the woman three-quar- 
ters of an hour afterward and found her pulseless and thoroughly exhausted. 
Thei'c was considerable but not excessive loss of blood, and several feet of 
intestine protruded through the wound. The womb was partially inverted 
through the wound, and the placenta was still attached to the inverted por- 
tion. The wound in the uterus was Y-shaped. The mother died in one and 
a half hours from the reception of her injuries, but the child was uninjured. 

Scott "^ mentions the instance of a woman thirty-four years old who was 
gored by an infuriated ox while in the ninth month of her eighth pregnancy. 
The horn entered at the anterior superior sjiinous process of the ilium, involv- 
ing the ]iarietes and the uterus. The child was extruded through the wound 
about half an hour after the occurrence of the accident. The cord was cut , 
and the child survived and thrived, though the mother soon died. Stalpart ^ ]/ 
tells the almost incredible story of a soldiei-'s wife whq went to obtain water 
from a stream and was cut in two by a cannonball while stooping over. A 
passing soldier ol)served something to move in the water, which, on investi- 
gation, he found to l)e a living child in its membranes. It was christened 
by order of one r\)rdua and lived for some time after. 

Postmortem Cesarean Section. — The possibility of delivering a child 

a 319, July, 1850, 88. ^ 538, 1867. c 518, 1885, iii., 341. d Dissert, de Foet. Nutrit., 45. 


by Cesarean section after the death of the mother has been known for a long 
time to the students of medicine. In the olden times there were laws making 
compulsory the opening of the dead bodies of pregnant women shortly after 
death. iSTuma Pompilius established the first law, which was called " lex 
regia," and in later times there were many such ordinances. A full 
description of these laws is on record.-^'^'^ Life was believed possible after a 
gestation of six months or over, and, as stated, some famous men were sup- 
posed to have been born in this manner. Frangois de Civile, who on great 
occasions signed himself " trois fois enterre et trois fois par le grace de Dieu, 
ressucit^," saw the light of the world by a happy Cesarean operation on his 
exhumed mother. Fabricius Hildanus and Bourton report similar instances. 
Bourton cites among others the case of an infant who Avas found living twelve 
hours after the death of his mother. Dufour " and Mauriceau °^^ are two older 
French medical writers who discuss this subject. Flajani^"*^ speaks of a case 
in which a child was delivered at the deatli of its mother, and some of the 
older Italian writers discuss the advisability of the operation in the moribund 
state before death actually ensues. Heister ^^^ writes of the delivery of the 
child after the death of the mother by opening the abdomen and uterus. 

Harris'' relates several interesting examples. In Peru in 1794 a Sambi i^ 
woman was killed by lightning, and the next day the abtlomen was opened by 
official command and a living child was extracted. The Princess von Swartzen- 
berg, who was burned to death at a ball in Paris in 1810, was said to have had 
a livins: child removed from her bodv the next dav. Like all similar instances, 
this was proved to be false, as her body was burned beyond the possibility of 
recognition, and, besides, she was only four months pregnant. Harris ^ men- 
tions another case of a young woman who threw herself from the Pont Neuf 
into the Seine. Her body was recovered, and a surgeon who was present 
seized a knife from a butcher standing by and extracted a living child in the 
presence of the curious spectators. Campbell ^^^ discusses this subject most 
thoroughly, though he advances no new opinions upon it. 

Duer tabulates the successful results of a number of cases of Cesarean 
section after death as follows : — 



•acted between 1 and 5 minutes after death of the 




" 10 and 15 " 

" " " 




" 15 and 30 " 

(( (I 11 

1 1 



1 hour 

11 (1 11 

1 1 



" 2 hours 

11 11 u 



Garezky of St. Petersburg ° collected reports of 379 cases of Cesarean 
section after death with the following results : 308 were extracted dead ; 37 
showed signs of life ; 34 were born alive. Of the 34, only 5 lived for any 
length of time. He concludes that if extracted within five or six minutes 
after death, they may be born alive ; if from six to ten minutes, they may 

a 462, T. xix., 263. ^ 125, 1880, 141. c Quoted by 545, Aug. 23, 1879. 


still be born alive, though asphyxiated ; if from ten to twenty-six minutes, 
they will be highly asphyxiated. In a great number of these cases the infant 
M'as asphyxiated or dead in one minute. Of course, if the death is sudden, 
as by apoplexy, accident, or suicide, the child's chances are better. These 
statistics seem conscientious and reliable, and we are safe in taking them as 
indicative of the usual result, which discountenances the old reports of death 
as taking place some time before extraction. 

Pencil ^ is credited with statistics showing that in 453 operations 101 chil- 
dren gave signs of life, but only 45 survived. 

During the Commune of Paris, Tarnier, one night at the ]\Iaternite, was 
called to an inmate who, while lying in bed near the end of pregnancy, had 
been killed by a ball which fractured the base of the skull and entered the 
brain. Pie removed the child by Cesarean section and it lived for several 
days. In another case a pregnant woman fell from a window for a distance 
of more than 30 feet, instant dfiath resulting ; thirty minutes at least after the 
death of the mother an infant was removed, which, after some difficulty, was 
resuscitated and lived for thirteen years. Tarnier states that delivery may 
take place three-quarters of an hour or even an hour after the death of the 
mother, and he also quotes an extraordinary case by Hubert of a successful 
Cesarean operation two hours after the mother's death ; the woman, wlio ^vas 
eight montlss pregrfant, was instantly killed while crossing a railroad track. '^ 

Hoftraan '^ records the case of a successful Cesarean section done ten min- 
utes after death. The patient Avas a woman of thirty-six, in her eighth month 
of pregnancy, who was suddenly seized Ayith eclampsia, wdiich terminated 
fatally in ten hours. Ten minutes after her last respiration the Cesarean sec- 
tion was performed and a living male child delivered. This infant was nour- 
ished with the aid of a spoon, but it died in twenty-five hours in consequence 
of its premature birth and enfeebled vitality. 

Green '^ speaks of a woman, nine months pregnant, who was run over l)y a 
heavily laden stage-coach in the streets of Southwark. She died in about 
twenty minutes, and in about twenty minutes more a living child was ex- 
tracted from her by Cesarean section. There was a similar case in the 
Hopital St. Louis, in Paris, in 1829 ; but in this case the child Avas born 
alive five minutes after death. Squire "^ tells of a case in which the mother 
died of dilatation of the aorta, and in from twenty to thirty minutes the child 
was saved. In comment on this case Aveling is quoted as saying that he 
believed it possible to save a child one hour after the death of the mother. 
ISo less an authority than Playfair speaks of a case in which a child was born 
half an hour after the death of the mother. Beckman '" relates the history of 
a woman who died suddenly in convulsions. The incision was made al)out 
five minutes after death, and a male child about four pounds in weight was 

a 844, 644. b 844, 645. c 261, 1895, No. 50, 1319. 

d 550, xii., 46-51. e 476, 1877, ii.. 89. f 199, 1869. 


extracted. The child exhibited feeble heart-contractions and was despaired of. 
Happily, after numerous and persistent means of resuscitation, applied for 
about two and a half hours, regular respirations were established and the 
child eventually recovered. Walter ^ reports a successful instance of removal 
of the child after the death of the mother from apoplexy. 

Cleveland '' gives an account of a woman of forty-seven which is of special 
interest. The mother had become impregnated five months after the cessa- 
tion of menstruation, and a uterine sound had been used in ignorance of 
the impregnation at this late period. The mother died, and one hour later a 
living child was extracted by Cesarean section. There are two other recent 
cases recorded of extraction after an hour had expired from the death. One 
is cited by Veronden '^ in which the extraction was two hours after deatli, 
a living child resulting, and the other by Blatner*^ in which one hour had 
elapsed after death, when the child was taken out alive. 

Cases of rupture of the uterus during pregnancy from the pressure 
of the contents and delivery of the fetus by some unnatural passage are 
found in profusion through medical literature, and seem to have been of 
special interest to the older observers. Benivenius ^ saw a case in which the 
uterus ruptured and the intestines protruded from the vulva. An instance 
similar to the one recorded by Benivenius is also found in the last century in 
Germany. '^^^ Bouillon '^ and Desbois, two French ])hysicians of the last 
century, both record examples of the uterus rupturing in the last stages of 
pregnancy and the mother recovering. Schreibers gives an instance of rupture 
of the uterus occasioned by the presence of a 1 3-pound fetus, and there is 
recorded ^ the account of a rupture caused by a 2()-})ound fetus that made its 
way into the abdomen. We find old accounts of cases of rupture of the 
uterus with birth by the vunbilicus and the recovery of the woman.' VespreJ 
describes a case in which the uterus was ruptured by the feet of the fetus. 

Farquharson^has an account of a singular case in midwifery in which the 
abdomen ruptured from the pressure of the fetus ; and quite recently Geo- 
ghegan ' illustrates the possibilities of uterine pressure in pregnancy by a post- 
mortem examination after a fatal parturition, in which the stomach Avas found 
pushed through the diaphragm and lying under the left clavicle. Heywood 
Smith™ narrates the particulars of a case of premature labor at seven months 
in which rupture of the uterus occurred and, notwithstanding the fact that 
the case was complicated by placenta prsevia, the patient recovered. 

Rupture of the uterus and recovery does not necessarily prevent subsequent 
successful pregnancy and delivery by the natural channels. Whiner}' ^ relates 

a 573, 1855, v., 179. b 125, 1878, xi., 626-632. c 78O, 1876, iv., 7. 

d 125, 1875, viii., 160. e L. iv., obs. B., 13. 

f Histoire de la Soc. Royale de Med., Paris, 1776, 310. g 160, iii., 235 

hSamml. Medic. Wahruehnmngeu, 1 B., 363. i 108, dec. i., viii., 90. 

J 462, T. xlii., 84. ^ n2A, 1789. 

1 465, 1881, 52. ^ 476, 1875, ii., 911. ° 124, Oct., 1866. 


an instance of a rii]>turc'd uterus in a healthy Irish woman of thirty-seven 
from whom a dead child was extracted by al)dominal section and who was 
safely delivered of a healthy female child about one year afterward. Analo- 
gous to this case is that of Lawrence,** who details the instance of a woman 
who had been delivered five times of dead children ; she had a very narrow 
pelvis and labor was always induced at the eighth month to assure delivery. 
In her sixtli pregnancy she had miscalculated her time, and, in C(»nse(iuence, 
her uterus ruptured in an ur.ex])ected parturition, but she recovered and had 
several subsequent pregnancies. 

Occasionally there is a spontaneous rupture of the vagina during the 
process of parturition, the uterus remaining iniact. A\ iltshire reptrts such a 
case in a woman who had a most prominent sacrum ; the laceration was trans- 
verse and quite extensive, l)ut the woman made a good recovery. Schauta 
pictures an exostosis on the promontory of the sacrum (Fig. 20). Blenkin- 
sop "^ cites an instance in wdiich the labor was neither protracted nor alj normally 
severe, yet the rupture of the vagina took place with the escape of the child 

into the abdomen of the mother, and was 
from thence extracted by Cesarean sec- 
tion. A peculiarity of this case was 
the easy expulsion from the uterus, no 
instrumental or other manual interfer- 
ence being attempted and the uterus 
remaining perfectly intact. 

In some cases there is extensive 
sloughing of the genitals after 
parturition with recovery far beyond 
„.„„,, ^ , , . , expectation. Gooch mentions a case 

J'lg. 20. — KnoD-hke exostosis on the |>romoutory ^ 

(Schauta). in wliicli the whole vagina sloughed^ 

yet to his surprise the patient recov- 
ered. Aetius and Benivenius speak of recovery in such cases after loss 
of the whole uterus. Cazenave of Bordeaux '^ relates a most marvelous 
case in Avhich a primipara suffered in labor from an impacted head. She 
was twenty-five, of very diminutive stature, and was in labor a long time. 
After labor, sloughing of the parts commenced and progressed to such an 
extent that in one month there were no traces of the labia, uymphse, vagina, 
perineum, or anus. There was simply a large opening extending from the 
meatus urinarius to the coccyx. The rectovaginal septym, the lower portion 
of the rectum, and the neck of the bladder were obliterated. The woman sur- 
vived, although she always experienced great difficulty in urination and in 
entirely emptying the rectum. A similar instance is reported '' in a woman 
of thirt}'' who was thirty-six hours in labor. The fundus of the uterus 

a 224, 1885, 601. b 656, No. xi., Dec. 2, 1841. 

c 330, No. 84, Feb. 7, 1839. d 124, Aug., 1838. 


descended into the vagina and the whole nterine apparatus was removed. 
The lower part of the rectum depended between the labia ; in the presence 
of the phvsician the nurse drew this out and it separated at the sphincter ani. 
On examining- the parts a single opening was seen, as in the preceding case, 
from the pubes to the coccyx. Some time afterward the end of the intestine 
descended several inches and lumg loosely on the concave surface of tlie rec- 
tum. A sponge was introduced to support the rectum and prevent access of 
air. The destruction of the parts was so complete and the opening so large 
as to bring into view the whole inner surface of the pelvis, in spite of which, 
after prolonged suppuration, the wound cicatrized from behind fonvard and 
health returned, exce})t as regards the inconvenience of fisces and urine. 
Milk-secretion appeared late and lasted two months without influencing the 
other functions. 

There are eases in wliicli, through the ignorance of the midwife or the 
physician, prolapsed pelvic organs are mistaken for afterbirth and ex- 
tracted. There have been instances in which the whole uterus and its ap- 
pendages, not being recognized, have been dragged out. AV^alters"^ cites the 
instance of a woman of twenty-two, who was in her third confinement. The 
midwife in attendance, finding the afterbirth did not come away, i)ulle(l at the 
funis, which broke at its attachment. She then introduced her liand and tore 
away what proved to be the whole of the uterus, with the right ovary and 
fallopian tube, a porti<Mi of the round ligament, and the left tube and o\arian 
ligament attached to it. A large (piantity of omentum protruded from the 
vulva and upper part of the vagina, and an enormous rent was left. Walters 
saw the woman twenty-one hours afterward, and ligated and severed the pro- 
truding omentum. On the twenty-eighth day, after a marvelous recovery, 
she was able to drive to the Royal Berkshire Hospital, a distance of five miles. 
At the time of report, two years and six months after the mutilation, she was 
in perfect health. Walters looked into the statistics of such cases and found 
36 accidental removals of the uterus in the puerperium with 14 recoveries. 
All l)ut three of these were without a doubt attended by previous inversion 
of the uterus. 

A medical man was tried for manslaughter in 1878'' because he made a 
similar mistake. He had delivered a woman by means of the forceps, and, 
after delivery, brought away what he thought a tumor. This " tumor " con- 
sisted of the uterus, with the placenta attached to the fundus, the funis, a por- 
tion of the lateral ligament, containing one ovary and about three inches of 
vagina. The uterus was not inverted. A horrible case, with similar results, 
happened in France, and was reported by Tardieu.'^ A brutal peasant, whose 
wife was pregnant, dragged out a fetus of seven months, together with the 
uterus and the whole intestinal canal, from within 50 cm. of the pylorus to 
within 8 cm. of the ileocecal valve. The woman was seen three-quarters of 

a 476, 1884, ii., 779. b 548, 1878, ii., 728. ^ 141, xxxix., 157, 172. 




an hour after the intestines had been found in tlie yard (where the brute had 
thrown them), still alive and reproaching her murderer. Hoffman '"* cites an 
instance in which a midwife, in her anxiety to extract the afterbirth, made 
traction on the cord, brought out the uterus, ovaries, and tubes, and tore the 
vulva and perineum as far as the anus. 

Woodson ^ tells the story of a negress who was four months pregnant, and 
who, on being seized with severe uterine pains in a bath, succeeded in seizing 
the fetus and dragging it >nit^ but inverting the nterus in the operation. 
There is a ease recorded "^ of a girl of eighteen, near her labor, who, being 
driven from her honse by her father, took refuge in a neighboring house, and 
soon felt the pains of child-birth. The accoucheur was stimmoned, pro- 
nounced them false pains, and went away. 
On his I'eturn he found the girl dying, 
with her uterus completely inverted and 
hanging between her legs. This unfor- 
tunate maiden had been delivered while 
standing upright, with her elbows on the 
back of a chair. The child suddenly 
escaped, bringing with it the uterus, but 
as the funis ruptured the child fell to the 
floor. Wagner pictures partial prolapse 
of the womb in labor (Fig. 21). 

It Mould too much extend this chap- 
tei- to include the many accidents inci- 
dent to labor, and only a few of especial 
interest will be given. Cases like rupture 
of an aneurysm during labor, extensive 
hemorrhage, the entrance of air into the 
uterine veins and sinuses, and common 
lacerations will be omitted, together with 
complicated births like those of double 
monsters, etc., but there are several other cases that deserve mention. 
Eldridge'* gives an instance of separation of the symphysis ])ubis during 
labor, — a natural symphysiotomy. A separation of | inch could be discerned 
at the symphysis, and in addition the sacroiliac synchondrosis was also quite 
movable. The woman had not been able to walk in the latter part of 
her pregnancy. The child weighed 10|^ pounds and had a large head in 
a remarkably advanced stage of ossification, with the fontanelles nearly 
closed. Delivery was effected, though during the passage of the head the 
pubes separated to such an extent that Eldridge placed two fingers between 
them. The mother recovered, and had perfect union and normal locomotion. 

Fig. 21.— Partial prolapse of the womb in labor 

a 807, 1865. 

c American System of Obstetrics, Hirst. 

h 124, 1860. 

d269, 1884, xlix., 495. 



Sanders ^ reports a case of the separation of the pubic bones in labor. 
Studlev ^ mentions a case of fracture of the pelvis during instrumental delivT 
ery, Humphreys '^ cites a most curious instance. The patient, it appears, 
had a large exostosis on the body of the pubes which, during parturition, was 
forced through the walls of the uterus and bladder, resulting in death. Kilian 
reports four cases of death from perforation of the uterus in this manner. 
Schauta pictures such an exostosis (Fig. 22). 

Chandler "^^ relates an instance in which there w^as laceration of the liver 
during parturition ; and Hubbard ^ records a case of rupture of the spleen 
after labor. 

Symphysiotomy is an operation consisting of division of the pubic symphy- 
sis in order to facilitate delivery in narrow pelves. This operation has under- 
gone a most remarkable revival during the past two years. It originated in a 
suggestion by Pineau in his work on surgery in 1598,'^ and in 1665 was first 
performed by La Courvee upon a dead body in order to save the child, and 
afterward by Plenk, in 1766,^ for the same purpose. In 1777 Sigault first 
proposed the operation on the living, 
and Ferrara was the one to carry out, 
practically, the proposition, — although 
Sigault is generally considered to be 
the first symphysiotomist, and the pro- 
cedure is very generally known as the 
" Sigaultean operation." From Fer- 
rara's time to 1858, when the oper- 
ation had practically died out, it had 
been performed 85 times, with a re- 
corded mortality of 33 per cent. In 1866 the Italians, under the leadership 
of Morisani of Naples, revived the operation, and in twenty years had per- 
formed it 70 times with a mortality of 24 per cent. Owing to rigid anti- 
septic technic, the last 38 of these operations (1886 to 1891) showed a mortality 
of only 5^ per cent., while the infant-mortality was only lOf percent. The 
modern history of this operation is quite interesting, and is veiy completely 
reviewed by Hirst and Dorland.*^ 

In Xovember, 1893, Hirst reported 212 operations since 1887, Avith a 
maternal mortality of 12.73 per cent, and a fetal mortality of 28 per cent. 
In his later statistics ]Morisani gives 55 cases with 2 maternal deaths and 
1 infantile death, while Zweifel* reports 14 cases from the Leipzig clinic 
with no maternal death and 2 fetal deaths, 1 from asphyxia and 1 from 
pneumonia, two days after birth. All the modern statistics are correspond- 
ingly encouraging. 

Fig. 22. — Exo.stosis on the symphysis (Schauta). 

a Trans. Amer. Instit. Homeopathy. 

c 531, 1857-8, iii., 322-326. d oig^ xxxiii., 398. 

f 533, Jan. 12, 1895. g 843, 401. "^ 843, 401. 

b 125, 1879, xii., 269. 

e 597, XXX., 75. 

i 261, No. 22, 1893. 


Invin reports a case in which the firm attachment of the fetal head to 
the uterine parietes rendered delivery without artificial aid ini})<)ssible, and it 
was necessary to perform craniotomy. The riu'ht temporal region of the ciiild 
adhered to the internal surface of the neck of the uterus, being connected by 
membranes. The woman was forty-four years old, and the child was her 

Delay in the Birth of the Second Twin. — In twin jn-egnancies there 
is sometimes a delay of m-my days in the birth of a second child, even to 
such an extent as to give suspicion of superfetation. Pignot speaks of one 
twin two months before the other. De Bosch speaks of a delay of seven- 
teen days ; and there were 2 cases on record in France in the last century, * 
one of which was delayed ten days, and the other showed an interval of seven 
weeks between the delivery of the twins. There is an old case on record ^ 
in which there was an interval of six weeks between deliveries ; Jansen ^'^^ 
arives an account of three births in ten months : Pinart "^ mentions a case with an 
interval of ten days ; Thilenius, one of thirteen days ; and E})liemerides, one of 
one week. Wildberg'^ describes a case in which one Xwm was l)orn two months 
after the other, and there was no secretion of milk until after the second 
birth. A full description of AVildberg's case is given in another journal ^ 
in brief, as follows : A woman, eighteen months married, was in labor in 
the eighth month of pregnancy. She gave birth to a child, which, though 
not fully matured, lived. There was no milk-secretion in her breasts, and 
she could distinctly feel the movements of another child ; her abdomen 
increased in size. After two months she had another labor, and a fully 
developed and strong child was born, much heavier than the first. On the 
third day after, the breasts became enlarged, and she experienced considerable 
fever. It was noticeable in this case that a placenta was discharged a quarter 
of an hour after the first birth. Irvine^ relates an instance of thirty-two 
days' delay ; and Pfau ^ one of seven days'. 

■si Carson ^ cites the instance of a noblewoman of forty, the mother of four 
children, who was taken ill about two weeks before confinement was expected, 
and was easily delivered of a male child, which seemed well formed, with 
perfect nails, but weakly. After the birth the mother never became healthy 
or natural in appearance. She was supposed to be dying of dropsy, but after 
forty-four days the mvsteiy was cleared by the birth of a fine, well-grown, 
and healthy daughter. Both mother and child did well. 

Addison ' describes the case of a woman who Avas delivered of a healthy 
male child, and eveiything was well until the evening of fhe fourth day, when 
intense labor-pains set in, and well-formed twins about the size of a pigeon's 
egg were born. In this strange case, possibly an example of superfetation, 

a 418, 1751, 107 ; and 418, 1752, 112. b leo, iv. B., 771. c 462, T. xl., 448. 

d 611, April 5, 184.5. e 136, 1844, 3 Heft. f 546, Dec. 28, 1844. 

g 611, April 20, 1844. h 224, 1880, i., 242. i 476, 1886, i., 477. 


the patient made a good recovery and the first child lived. A similar case 
is reported by Lumby ^ in which a woman was delivered on January 18th, 
by a midwife, of a full-grown and healthy female child. On the third day 
she came down-stairs and resumed her ordinary duties, which she con- 
tinued until February 4th (seventeen days after). At this time she was de- 
livered of twins, a boy and a girl, healthy and well-developed. The placenta 
was of the consistency of jelly and had to be scooped away with the hand. 
The mother and children did well. This woman was the mother of ten children 
besides the product of this conception, and at the latter occurrence had entire 
absence of pains and a very easy parturition. 

Pincott ^ had a case with an interval of seven weeks between the births ; 
Vale "^ 1 of two months ; Bush '^ 1 of seventeen days ; and Burke ® 1 with an 
interval of two months. Douglas ^ cites an instance of twins being born four 
days apart. Bessems of Ant\verp, in 186G, mentions a woman Mith a bicor- 
nate uterus who bore two twins at fifty -four days' interval. 

a 224, 1878, i., 227. b 224, 1886. c 476, 1842. 

d535, 1825, 121. e 532, 1855, 241. f 538, xxvii., 196. 


General Historic Observations. — Prolil^oity is a much discussed sub- 
ject, fur besides its medical and general interest it is of importance in social 
as well as in political economy. Supei'fluous population was a question that 
came to consciousness early ; Aristotle spoke of legislation to prevent the in- 
crease of population and the physical and mental deterioration of the race, — 
he believed in a population lixed as regards numbers, — and later Lycurgus 
transformed these precepts into a terrible law. Strabonius reports that the 
inhabitants of Cathea brought their infants at the age of two months before a 
magistrate for inspection. The strong and promising Mere preserved and the 
weak destroyed. The founders of the Roman Empire followed a similar 
usage. 'With great indignation Seneca, Ovid, and Juvenal reproved this 
barbarity of the Romans. AVith the domination of Christianity this custom 
gradually diminished, and Constantine stopped it altogether, ordering succor 
to the people too poor to rear their own children. The old Celts were so 
jealous of their vigor that they placed their babes on a shield in the river, 
and regarded those that the waves respected as legitimate and worthy to 
become members of their clans. In many of the Oriental countries, Avhere the 
population is often very excessive and poverty great, the girl babies of the 
lower classes were destroyed. At one time the crocodiles, held sacred in the 
Xile, were given the surplus infants. By destroying the females the breed- 
ing necessarily diminished, and the number of the weaker and dependent 
classes became less. In other countries persons having children beyond their 
ability to support were privileged to sell them to citizens, who contracted to 
raise them on condition that they became their slaves. 

General Law, and the Influence of War. — In the increase of the 
world's population, although circumstances may for the time alter it, a 
general average of prolificity has, in the long run, been maintained. In the 
history of every nation artificial circumstances, such as fashion, war, poverty, 
etc., at some period have temporarily lowered the average of prolificity ; but 
a further search finds another period, under opposite circumstances, which 
will more than compensate for it. The effect of a long-continued war or wars 
on generation and prolificity has never been given proper consideration. In 
such times marriages become much less frequent ; the husbands are separated 



from their wives fur long periods ; many women are left widows ; the females 
become in excess of the males ; the excitement of the times overtops the desire 
for sexual intercourse, or, if there is the same desire, the unprolitic prostitute 
furnishes the satisfaction ; and such ficts as these, coupled with many similar 
ones, soon produce an astonishing eifect upon the comparative birtli-rate and 
death-rate of the country. The resources of a country, so far as concerns 
population, become less as the period of peace-disturbance is prolonged. 
Mayo-Smith^ quotes von Mayr in the following example of the influence 
of the war of 1870-71 on the birth-rate in Bavaria, — the figures for births 
are thrown back nine months, so as to show the time of conception : Before 
the war under normal conception the number of births was about 1(3,000 
per month. During the war it sank to about 2000 per month. Immediately 
on the cessation of hostilities it arose to its former number, while the actual 
return of the troops brought an increase of 2000 per month. The maximum 
was reached in March, 1872, when it was 18,450. The war of 1866 seems 
to have passed over Germany without any great influence, the birth-rate in 
1865 being 39.2; in 1866, .-39.4; in 1867, 38.3; in 1868, 38.4. On the 
other hand, while the birth-rate in 1870 was 40.1, in 1871 it was only 35.9 ; 
in 1872 it recovered to 41.1, and remained above 41 down to 1878. Yon 
Mayr believes the war had a depressing influence upon the rate apart from 
the mere absence of the men, as shown in the fact that immediately upon the 
cessation of hostilities it recovered in Bavaria, although it was several months 
before the return of the tro(»ps. 

Mayo-Smith, in remarking on the influence of war on the marriage-rate, 
says that in 1866 the Prussian rate fell from 18.2 to 15.6, while the Austrian 
rate fell from 15.5 to 13.0. In the war of 1870-71 the Prussian rate fell from 
17.9 in 1869 to 14.9 in 1870 and 15.9 in 1871 ; but in the two years after 
peace was made it rose to 20.6 and 20.2, the highest rates ever recorded. In 
France the rate fell from 16.5 to 12.1 and 14.4, and then rose to 19.5 and 
17.7, the highest rates ever recorded in France. 

Influence of Rural and Urban Life. — Rural districts are always very 
prolific, and when we hear the wails of writers on " Social Economy," bemoan- 
ing the small birth-rates of their large cities, we need have no fear for urban 
extinction, as emigration from the countrv^ by many ambitious sons and 
daughters, to avail themselves of the superior advantages that the city offers, 
will not only keep up but to a certain point increase the population, until the 
reaction of overcrowding, following the self-regulating law of compensation, 
starts a return emigration. 

The effect of climate and race on prolificity, though much spoken of, 
is not so great a factor as supposed. The inhabitants of Great Britain are 
surpassed by none in the point of prolificity ; yet their location is quite 
northern. The Swedes have always been noted for their fecundity. Olaf 

a Statistics and Sociology, New York, 1895. 


Rudbeck * says that from 8 to 1 2 was the usual family number, and some ran 
as high as 25 or 30. According to Lord Kanies, in Iceland before the 
plague (about 1710) families of from 15 to 20 were quite conniion. The old 
settlers in cold North America were always blessed with large families, and 
Quebec is still noted for its prolificity. There is little difference in this respect 
among nations, woman being limited about the same everywhere, and the 
general average of th(» range <^i the })roductive function remaining nearly 
identical in all nations. Of course, exception must be made as to the extremes 
of north or south. 

Ancient and Modern Prolificity. — Xor is there much difference between 
ancient and modern times. A\'e read in the writings of Aristotle, Pliny, and 
Albucasis of the wonderful fertility of the Avomen of Egypt, Arabia, and 
other warm countries, from 3 to 6 children often being born at once and 
living to maturity ; but from the wonder and surprise shown in the narration 
of these facts, they were doubtless exceptions, of which ]iarallels may be found 
in the present day. The ancient Greek and Roman families were no larger 
than those of to-day, and were smaller in the zenith of Roman affluence, and 
continued small until the })erio(l of decadence. 

Legal Encouragement of Prolificity. — In Quebec Province, Canada, 
according to a Montreal authority,'' 100 acres of land are allotted to the father 
who has a dozen children by legitimate marriage. The same journal states 
that, stimulated by the premium offered, families of 20 or more are not rare, 
the results of patriotic efforts. In 1895, 1742 "chefs de famille" made 
their claim according to the conditions of the law, and one, Paul Bellanger, 
of the River du Loup, claimed 300 acres as his premium, based on the fact 
that he was the father of 36 children. Another claimant, Monsieur Thioret 
de Sainte Genevieve, had been presented by his wife, a woman not yet thirty 
years old, with 17 children. She had triplets twice in the space of five years 
and twins thrice in the mean time. It is a matter of conjecture what the 
effect would be of such a premium in countries with a lowering birth-rate, 
and a French medical journal, quoting the foregoing, regretfully wishes for 
some countrymen at home like their brothers in Quebec. 

Old Explanations of Prolificity. — The old explanation of the causation 
of the remarkable exceptions to the rules of prolificity was similar to that- 
advanced by Empedocles, who says that the greater the quantity of semen, the 
greater the number of children at birth. Pare,^^^ later, uses a similar reason 
to explain the causation of monstrosities, grouping them into two classes, those 
xlue to deficiency of semen, such as the acephalous type, and those due to ex- 
fcees, such as the double monsters. Hippocrates, in his work on the " Nature 
(0,f fhe Infant," tells us that twins are the result of a single coitus, and we are 
-also infi)rmed that each infiint has a chorion ; so that both kinds of plural 
gestation (monochorionic and dichorionic) were known to the ancients. In tnis 

a Atlantica, Upsal, 1684. b 788, June, 1895. 


treatise it is further stated that the twins may be male or female, or both 
males or both females ; the male is formed when the semen is thick and strong. 

The greatest number of children at a single birth that it is possible 
for a woman to have has never been definitely determined. Aristotle gives it 
as his opinion that one woman can bring forth no more than 5 children at a 
single birth, and discredits reports of multiplicity above this number ; wdiile 
Pliny, who is not held to be so trustworthy, positively states that there were 
authentic records of as many as 12 at a birth. Throughout the ages in which 
superstitious distortion of facts and unquestioning credulity was unchecked, 
all sorts of incredible accounts of proliiicity are found. Martin Cromerus, a 
Polish historian, quoted by Pare, wdio has done some good work in statistical 
research on this subject, says^ that Margaret, of a noble and ancient family 
near Cracovia, the wife of Count Virboslaus, brought forth 36 living children 
on January 20, 1296. 

The celebrated case of Countess Margaret, daughter of Florent IV., Earl 
of Holland, and spouse of Count Hermann of Henneberg, was supposed to 
have occurred just before this, on Good Friday, 1278. She was at this time 
forty-two years of age, and at one birth brought forth 365 infants, 182 males, 
182 females, and 1 hermaphrodite. They were all baptized in two large 
brazen dishes by the Bisliop of Treras, the males being called John, the 
females Elizabeth. During the last century the basins were still on exhibi- 
tion in the vijlage church of Losdun, and most of the visitors to Hague went 
out to see them, as they were reckoned one of the curiosities of Holland. The 
affliction was ascribed to the curse of a poor woman who, holding twins in her 
arms, approached the Countess for aid. She was not only denied alms, but 
was insulted by being told that her twins Avere by different fathers, whereupon 
the poor woman prayed God to send the Countess as many children as there 
were days in the year. There is room for much speculation as to what this 
case really was. There is a possibility that it was simply a case of hydatidi- 
form or multiple molar pregnancy, elaborated by an exhaustive imagination 
and superstitious awe. As late as 1799 there was a woman of a town of 
Andalusia who was reported to have been delivered of 16 male infants, 7 of 
which were alive two months later. 

Mayo-Smith remarks that the proportion of multiple births is not more 
than 1 per cent, of the total luuul^er of parturitions. The latest statistics, by 
Westergaard, give the following averages to number of cases of 100 births 
in which there w^ere 2 or more at a birth : — 

Sweden, . . , .1.45 German}', 1.24 Bavaria, . . . .1.38 

Denmark, . . . .1.34 Holland 1.30 Prassia, . . • .1.26 

Scotland, . . . .1.22 Norway, 1..32 Saxony, . . . • 1.20 

Italy, 1.21 Austria, 1.17 Switzerland, . .1.16 

Prance, 0.99 Belgium, 0.97 Spain, 0.85 

a 618, 1014. 


In Prussia, from 1826 to 1880, there were 85 cases of quadruplets and 3 
cases of 5 at a l)iiih. 

The most extensive statistics in regard to multiple births are those of Veit, 
who reviews 13,000,000 births in Prussia. According to his deductions, 
twins occur once in 88 births ; triplets, once in 7910 ; and quadruplets, once 
in 371,126. Recent statistics supplied by the Boards of Health of New 
York and Philadelphia place the frequency of twin births in these cities at 1 
in every 120 birtlis, while in Bohemia twins occur once in about 60 births, a 
proportion just twice as great.^ Of 150,000 twin pregnancies studied by 
Veit, in one-third both children were boys ; in slightly less than one-third 
both were girls ; in the remaining third both sexes were represented. 

Authentic records of 5 and 6 at a birth are extremely rare and infinitesimal 
in proportion. The reputed births in excess of 6 must be looked on with 
suspicion, and, in fact, in the great majority of reports are apochr^phal. 

The examples of multiple births of a single pregnancy will be taken 
up under their respective numbers, several examples of each being given, 
together with the authorities. Many twin and triplet brothers have figured 
prominently in history, and, in fact, they seem especially favored. The 
instance of the Horatii and the Curatii, and their famous battle, on which 
hung the fate of Rome and Alba, is familiar to every one, their strength and 
wisdom being; Icgendarv with the Romans. 

Twins and triplets, being quite common, will not be considered here, 
although there are 2 cases of interest of the latter that deserve citation. 
Sperling ^^^ reports 2 instances of triplets ; in the first there was 1 placenta 
and chorion, 2 amnions, and the sex was the same ; in the second case, in 
which the sexes were different, there were 3 placentas, 3 chorions, and 3 
amnions. What significance this may have is only a matter of conjecture. 
Petty ^ describes a case of triplets in which one child was born alive, the other 
2 having lost their vitality three months before. ]\Iira})pau'^ has recently 
found that triple births are most common (1 to 6500) in multiparous women 
between thirty and thirty-four years of age. Heredity seems to l)e a factor, 
and duplex uteruses predispose to multiple births. Ross '^ reports an instance 
of double uterus with triple pregnancy. 

Quadruplets are supposed to occur once in about every 400,000 births. 
There are 72 instances recorded in the Index Catalogue of the Surgeon 
General's Library, U. S. A., up to the time of compilation, not including the 
subsequent cases in the Index Medicus. At the Hotel-Dieu, in Paris, in 
108,000 births, covering a period of sixty years, mostly in the last century, 
there was only one case of quadruplets. The following extract of an account 
of the birth of quadruplets is given by Dr. He Leon of Ingersoll, Texas : — 

" I was called to see Mrs. E. T. Page, January 10, 1890, about 4 o'clock 

a S44, 142. *> 490, 1845. 

c Ueber Dri]linp;.sa;eburteii, Miinehen, 1894. ^ Medecin. Pnris, 1879. v.. No. 43, 2. 


A. M. ; found her in labor and at full time, although she assured me that her 
* time ' was six weeks ahead. At 8 o'clock a. m. I delivered her of a girl 
baby; I found there were triplets, and so informed her. At 11 a.m. I 
delivered her of the second girl, after having rectified presentation, which 
was singular, face, hands, and feet all pi^esented ; I placed in proper position 
and practised 'version.' This child was * still-born,' and after considerable 
effort by artificial respiration it breathed and came around 'all right.' 
The third girl was born at 11.40 a.m. This was the smallest one of the 
four. In attempting to take away the placenta, to my astonishment I 
found the feet of another child. At 1 p. m. this one was born ; the head 
of this child got firmly ini])acted at the lower strait, and it was with a great 
deal of difficulty and much patient effort that it was finally disengaged ; it 
was blocked by a mass of placenta and cords. The first child had its own 
placenta; the second and third had their placenta; the fourth had also a 
placenta. They weighed at birth in the aggregate 191^ pounds without cloth- 
ing ; the first weighed 6 pounds ; the second 5 pounds ; the third 4J pounds ; 
the fourth 4 pounds. Mrs. Page is a blonde, about thirty-six years old, and 
has given birth to 14 children, twins three times before this, one pair by her 
first husband. She has l>cen married to Pao:e three vears, and has had 8 
children in that time, I have waited on her each time. Page is an 
Englishman, small, with dark hair, age about twenty-six, and weighs about 
115 pounds. They are in St, Joseph, Mo., now, having contracted with Mr, 
Utfner of New York to travel and exhibit themselves in Denver, St. Joseph, 
Omaha, and Nebraska City, then on to Boston, ]\Iass., where they Avill spend 
the summer." 

There is a report from Canada^ of the birth of 4 living children at 
one time. The mother, a woman of thirty-eight, of small stature, weighing 
100 pounds, had 4 living children of the ages of twelve, ten, eight, and 
seven years, respectively. She had aborted at the second month, and at full 
term was delivered of 2 males, weighing, respectively, 4 pounds 9| ounces 
and 4 pounds 3 ounces ; and of 2 females, weighing 4 pounds 3 ounces and 
3 pounds 13f ounces, respectively. There was but one placenta, and no 
more exhaustion or hemorrhage than at a single birth. The father weighed 
169 pounds, was forty-one years old, and was 5 feet 5 inches tall, healthy 
and robust. The Journal of St. Petersburg, a newspaper of the highest 
standard, stated that at the end of July, 1871, a Jewish woman residing 
in Courland gave birth to 4 girls, and again, in INIay, 1872, bore 2 boys and 
a girl ; the mother and the 7 children, born within a period of ten months, 
were doing well at the time of the report. In the village of Iwokina, on 
May 26, 1854,^ the wife of a peasant bore 4 children at a birth, all surviv- 
ing, Bousquet ^ speaks of a primiparous mother, aged twenty- four, giving 
birth to 4 living infants, 3 by the breech and 1 by the vertex, apparently all 

a 250, Oct., 1883. b 476, 1857, ii., 259. c 140, 1894, ii., 55. 


in one bag of membranes. They were nourished by the help of 3 wet-nurses. 
Bedford *' speaks of 4 children at a birth, averaging 5 pounds each, and all 
nursing the mother. 

Quintuplets are quite rare, and the Index Catalogue of the Surgeon 
General's Library, U. S. A., gives only 19 cases, reports of a few of which 
will be given here, together with others not given in the Catalogue, and from 
less scientific though reliable sources. In the year 1731 -^- there was one 
case of quintuplets in Upper Saxony and another near Prague, Bohemia. In 
both of these cases the children were all christened and had all lived to 
maturity. Garthshore^ speaks of a healthy woman, Margaret Waddington, 
giving birth to 5 girls, 2 of which lived ; the 2 that lived weighed at 
birth 8 pounds 12 ounces and 9 pounds, respectively. He discusses the 
idea that woman was meant to bear more than one child at a birth, using 
as his argument the existence of the double nipple and mamma, to which 
might be added the not infrequent occurrence of polymazia. 

In March, 1736, '^ in a dairy cellar in the Strand, London, a poor woman 
gave birth to 3 boys and 2 girls. In the same journal was reported the birth 
at Wells, Somersetshire, in 1739, of 4 boys and a girl, all of whom were 
christened and were healthy. Pare *^ in 1549 gives several instances of 5 
children at a birth, and Pliny reports that in the peninsula of Greece there 
was a woman who gave birth to quintuplets on four different occasions. 
Petritus, a Greek physician,® speaks of the birth of quintuplets at the seventh 
month. Two males and one female were born dead, being attached to the 
same placenta ; the others were united to a common placenta and lived three 
days. Chambon ^ mentions an instance of 5 at a birth. Xot far from Berne, 
Switzerland, the wife of John Gelinger, a preacher in the Lordship of 
Berne, brought forth twins, and within a year after she brought forth 
quintuplets, 3 sons and 2 daughters.^ There is a similar instance 
reported in 1827*^ of a woman of twenty-seven who, having been delivered 
of twins two years before, was brought to bed with 5 children, 3 boys and 2 
girls. Their length was from 15 J to 16 J inches. Although regularly formed, 
they did not seem to have reached maturity. The mother was much exhausted, 
but recovered. The children appeared old-looking, had tremulous voices, and 
slept continually ; during sleep their temperatures seemed very low. 

Kennedy^ showed before the Dublin Pathological Society 5 fetuses with 
the involucra, the product of an abortion at the third month. At Xaples 
in 1839 Giuseppa Califani gave birth to 5 children ; and about the same 
time Paddock reported the birth in Franklin County, Pa., of quintuplets. 
The Lancet J relates an account of the birth of (juintuplets, 2 boys and 
3 girls, by the wife of a peasant on March 1, 1854. ]Moffitt^ records the 

a 538, 1867. ^ 629, 1787, 344. c 374^ Oct. o, 1736. 

d 618, L. XXV., chap, iii., 54. e 302, iv., 183. f 302, xix., 389. g 618, 1014. 
b371, T. ii., 1827. i 476, 1837, 743. J 476, 1857, ii., 259. 1^:545, 1881. 


birth at Monticello, 111., of (juintuplets. Tiie woman was thirty-five years 
of age ; examination showed a breech presentation ; the second child Was 
born by a foot-presentation, as was the third, but the last was by a head- 
presentation. The combined weight was something over 19 pounds, and 
of the 5, 3 were still-born, and the other 2 died soon after birth. The 
Elgin Courant (Scotland), 1858, speaks of a woman named Elspet Gordon, 
at Rothes, giving birth to 3 males and 2 females. Although they were 
six months' births, the boys all lived until the following morning. The girls 
were still-born. One of the boys had two front teeth when born. Dr. 
Dawson of Rothes is the obstetrician mentioned in this case. 

The following recent instance is given with full details to illustrate the 
difficulties attending the births of quintuplets. Stoker ^ has reported the case 
of a healthy woman, thirty-five years old, o feet 1 inch high, and of slight 
build, whom he delivered of 5 fetuses in the seventh month of pregnancy, 
none of the children surviving. The patient's mother had on two occasions 
given birth to twins. The woman herself had been married for six years and 
had borne 4 children at full term, having no difficulty in labor. When she 
came under observation she computed that she had been pregnant for six 
months, and had had her attention attracted to the unusually large size of 
her abdomen. She complained of fixed pain in the leftside of the abdomen, 
on which side she thought she was larger. Pains set in with regularity and 
tlie labor lasted eight and three-quarter hours. After the rupture of the 
membranes the first child presented by the shoulder. Version was readily 
performed ; the child was dead (recently). Examination after the birth of 
the first child disclosed the existence of more than one remaining fetus. 
The membranes protruded and became tense with each contraction. The 
presentation was a transverse one. In this case also there Avas little difficulty 
in effecting internal version. The child lived a couple of hours. The third 
fetus was also enclosed in a separate sac, which had to be ruptured. The 
child presented by the breech and was delivered naturally, and lived for an 
hour. In the fourth case the membranes had likewise to be ruptured, and 
alarming hemorrhage ensued. Version was at once practised, but the chin 
became locked with that of the remaining fetus. There was some difficulty 
and considerable delay in freeing the children, though the extent of locking 
was not at any time forniidal>le. The child was dead (recently). The fifth 
fetus presented by the head and was delivered naturally. It lived for half 
an hour. The placenta was delivered about five minutes after the birth of 
the last child, and consisted of two portions united by a narrow isthmus. 
One, the smaller, had two cords attached centrally and close together; the other, 
and larger, had two cords attached in a similar way and one where it was joined 
to the isthmus. The organ appeared to be perfectly healthy. The cord of 
the fourth child was so short that it had to be ligated in the vagina. The 

a 476, 1895, ii., 1164. 



children were all females and of about the same size, making a total weight 
of 8 pounds. The mother rallied quickly and got on well. 

Trustworthy records of sextuplets are, of course, extremely scarce. There 
are few catalogued at Washington, and but two authentic cases are on record 
in the United States. On December 30, ISol,'^''^ a woman in Dropin 
was delivered of 6 daughters, all living, and only a little smaller than 
usual in size. The mother Avas not quite twenty years old, but was of 
strong constitution. The 6 lived long enough to be baptized, but died the 
evening of their births. There was a case'"' of sextuplets in Italy in 1844. 
In Maine, June 27, 1847, a woman was delivered of 6 children, 2 sur- 
viving and, together with the mother, doing well.^' In 188") there was 
reported the birth of sextuplets in Lorca, Spain, of which only one survived. '^ 
At Dallas, Texas, in 1888,'^ Mrs. George Hirsh of Navarro County gave birth 
to 6 children, the mother and the children all doing well. There were 4 boys 
and 2 girls, and they were all perfect, well formed, but rather small. 

Valsalli'^ gives an instance which is quoted by the Medical Xews^ without 
giving the authority, Valsalli's account, which differs slightly from the 
account in the Medical News, is briefly as follows : AMiile straining at stool 
on the one hundred and fifteenth day of pregnancy the membranes ruptured 
and a foot prolapsed, no pain having been felt before the accident. A fetus 
was delivered by the midwife. Valsalli was summoned and found the woman 
with an enormously distended abdomen, within which were felt numerous fetal 
parts ; but no fetal heart-sounds or movements were noticed. The cervix was 
only slightly dilated, and, as no pains were felt, it was agreed to wait. On 
the next day the membranes were ruptured and 4 more fetuses were deliv- 
ered. Traction on the umbilical cord started hemorrhage, to check which the 
physician placed his hand in the uterine cavity. In this most arduous posi- 
tion he remained four hours until assistance from Lugano came. Then, in 
the presence of the three visitiug physicians, a sixth amniotic sac was deliv- 
ered with its fetus. The woman had a normal convalescence, and in the fol- 
lowing year gave birth to healthy, living twins. The News says the chil- 
dren all moved vigorously at birth ; there were 4 males and 2 females, and 
for the 6 there was only one placenta. The mother, according to the same 
authority, was thirty-six years of age, and Avas in her second pregnancy. 

Multiple Births over Six. — When we pass sextuplets the records of 
multiple births are of the greatest rarity and in modern records there are 
almost none. There are several cases mentioned by the older writers whose 
statements are generally worthy of credence, which, however incredible, are of 
sufficient interest at least to find a ]>lace in this chapter. Albucasis affirms 
that he knew of the birth of seven children at one time ; and d'Alechampius 
reports that Bonaventura, the slave of one Savelli, a gentleman of Siena, gave 

a 152, 1844, :MH. fe 218, 1847. c 373, isSfi. 

d 450, Nov. 17, 1888. e 36O, 1888. f 533, March 23, 1895. 



birth to 7 children, 4 of whom were baptized. At the Parish of San Ildefonso, 
Valladolid, Julianna, wife of Benito Quesada, gave birth to 3 children in one 
day, and during the following night to 4 more.''' Sigebert, in his Chronicles, 
says that the mother of the King of Lombardy had borne 7 children at a 
birth. Borellus '' savs that in 1650 the lady of the then present Lord Darre 
gave birth to eight perfect children at one parturition and that it was the 
unusual event of the country. 

Mrs. Timothy Bradlee of Trumbull County, Ohio, m 1872 is reported to 
have given birth to 8 children at one time.'' They were healthy and living, 
but quite small. The mother was married six years previously and then weighed 
273 pounds. She had given birth to 2 
pairs of twins, and, with these 3 boys 
and 5 girls, she had borne 12 children 
in six years. She herself was a triplet 
and her father and her mother were of 
twin births and one of her grandmothers 
was the mother of 5 pairs of twins. 
This case was most celebrated and was 
much quoted, several British journals 
extracting it. 

Watering of Maregnac '^ speaks of 
the sinudtaneous birth of 8 children at 
one time. When several months j)reg- 
nant the Avoman was seized with colicky 
pains and thought them a call of nature. 
She went into a vineyard to answer it, 
and there, to her great astonishment, 
gave birth to 8 fetuses. Watering found 
them enclosed in a sac, and thought 
they probably had died from mutual 
pressure during growth. The mother 
made a good recovery. 
yj In 1755 Seignette of Dijon® reports 

/ the simultaneous birth of nine children. Franciscus Picus ^Nlirandulse, 
quoted by Pare, says that one Dorothea, an Italian, bore 20 children at 2 
confinements, the first time bearing 9 and the second time eleven. He 
gives a picture of this marvel of ])rolificity, in which her lielly is represented 
as hanging down to her knees, and supported l)y a girdle from the neck 
(Fig. 23). In the Annals, History, and Guide to Leeds and York, according 
to Walford,^^-^ there is mention of Ann Birch, who in 1781 was delivered 

Fig. 23.— Pregnancy with 11 fetuses (after Par6). 

a 373, Nov. 22, 1885 ; quoted by 476, 1885, ii., 1125 ; aud several other authorities, 
b Observ., cent, ii., Paris, 1656. «= 218, Sept. 26, 1872. 

^ 349, June, 1880. « 280, 1755, i., 300. 


of 10 children. One daughter, the sole survivor of the 10, married a market 
gardener named Piatt, who was well known in Leeds. Jonston^^' quotes 
Baytraif as saying that he knew of a case in which 9 children were born 
simultaneously ; and also says that the Countess of Altdorf gave birth to 
twelve at one birth. Albucasis mentions a case of fifteen well-formed 
children at a birth. According to Le Brun," Gilles de Trazegines, who 
accompanied Saint Louis to Palestine, and who was made Constable of 
France, was one of thirteen infants at a simultaneous accouchement. The 
Marquise, his mother, was impregnated by her husband before his departure, 
and during his absence had 13 living children. She was suspected by the 
native people and thought to be an adulteress, and some of the children 
were supposed to be the result of superfetation. They condemned them 
all to be drowned, but the Marquis appeared upon the scene about this time 
and, moved by compassion, acknowledged all 13. They grew up and thrived, 
and took the name of Trazegines, meaning, in the old language, 13 drowned, 
although many commentaries say that "gine.s" was supposed to mean in the 
twelfth century " ncx/^ or, in full, the interpretation would be "13 born." 

Cases in which there is a repetition of multiple births are quite numer- 
ous, and sometimes so often repeated as to produce a family the size of which 
is almost incredible. Aristotle is credited with saying ^^ that he knew the 
history of a woman who had quintuplets four times. Pliny's case of quin- 
tuplets four times repeated has been mentioned ; and Pare,^^^ who may be 
believed when he quotes from his own experience, says that the wife of the 
^ last Lord de ^Nlaldemeure, who lived in the Parish of Seaux, was a marvel 
/ of prolificity. Within a year after her marriage she gave birth to twins ; 
in the next year to triplets ; in the third year to quadruplets ; in the fourth 
year to qtiintuplets, and in the fifth year bore sextuplets ; in this last labor she 
died. The then present Lord de Maldemeure, he says, was one of the final 
sextuplets. This case attracted great notice at the time, as the family was 
quite noble and very well known. Seaux, their home, was near Chaml)ellay. 
Picus Mirandulae gathered from the ancient Egyptian inscriptions that the 
women of Egypt brought forth sometimes 8 children at a birtii, and that one 
woman bore 30 children in 4 confinements. He also cites, from the 
history of a certain Bishop of Necomus, that a woman named Antonia, in 
the Territory of Mutina, Italy, now called Modena, had brought forth 40 
sons before she was forty years of age, and that she had had 3 and 4 at 
a birth. At the auction of the San Donato collection of pictures a portrait 
/J of Dianora Frescobaldi, Ijy one of the Bronzinos in the sixteenth century, 
I sold for about $3000. At the l^ottom of this portrait was an inscription 
stating that she was the mother of 52 children. This remarkal)le woman 
never had less than 3 at a birth, and tradition gives her as many as 6. 

Merriman *= quotes a case of a woman, a shopkeeper named Blimet, who 
a 302, iv., 183. ^ 302, xix., 389. c 374, Sept., 1783, iii , 753. 


had 21 children in 7 successive births. They were all born alive, and 12 
still survived and were healthy. As though to settle the question as to 
whom should be given the credit in this case, the father or the mother, the 
father experimented upon a female servant, who, notwithstanding her youth 
and delicateness, gave birth to 3 male children that lived three weeks. 
According to despatches from Lafayette, Indiana, investigation following the 
murder, on December 22, 189'"), of Hester Curtis, an aged woman of that 
citv, developed the rather remarkable fact that she had been the mother of 
25 children, including 7 pairs of twins. 

According to a French authority the wife of a medical man at Fuente- 
major, in Spain, forty-three years of age,-' was delivered of triplets 13 
times. Puech read a paper before the French Academy in which he re- 
ports 1262 twin births in Nimes from 1790 to 1875, and states that of the 
whole number in 48 cases the twins were duplicated, and in 2 cases 
thrice repeated, and in one case 4 times repeated. 

Warren'' gives an instance of a lady, Mrs. M , thirty-two years 

of age, married at fourteen, who, after the death of her first child, V)ore 
twins, one living a month and the other six weeks. Later she again 
bore twins, both of whom died. She then miscarried with triplets, and 
afterward gave birth to 12 living children, as follows: July 24, 1858, 1 
child; June 30, 1859, 2 children; March 24, 1860, 2 children; March 
1, 1861, 3 children; February 13,1862, 4 children; making a total 
of 21 children in eighteen years, with remarkable prolificity in the later 
pregnancies. She was never confined to her bed more than three days, and 
the children were all healthy. 

A woman in Schlossberg, Germany, gave birth to twins ; after a year, to 
triplets, and again, in another year, to 3 fairly strong boys.'^ In the 
State Papers, Domestic Series, Charles I., according to Walford,^i^ appears 
an extract from a letter from George Garrard to Viscount Conway, which is 
as follows : '^ Sir John Melton, who entertained you at York, hath buried 
his wife, Curran's daughter. Within twelve months she brought him 4 
sons and a daughter, 2 sons last summer, and at this birth 2 more and 
a daughter, all alive." Swan*^^ mentions a woman who gave birth to 6 
children in seventeen months in 2 triple pregnancies. The first terminated 
prematurely, 2 children dying at once, the other in five weeks. The sec- 
ond was uneventful, the 3 children living at the time of the report. 
Rockwell "^ gives the report of a case of a woman of twenty-eight, herself a 
twin, who gave birth to twins in January, 1879. They died after a few 
weeks, and in March, 1880, she again bore twins, one living three and the 
other nine weeks. On March 12, 1881, she gave birth to triplets. The 
first child, a male, weighed 7 pounds ; the second, a female, 6| pounds ; the 

a 365, Oct. 1, 1863. b 218, 1862, 331. <= 224, 1878, ii., 767. 

•1 512, March, 1893. e 612, Columbus, 1881. 


third, a male, oj pounds. The tliird child lived twenty days, the other two 
died of cholera infautuiu at the sixth mouth, attributable to the bottle-feed- 
ing. Banerjee^ gives the history of a case of a woman of thirty being de- 
livered of her fourth pair of twins. Her mother was dead, but she had 
3 sisters living, of one of which she was a twin, and the other 2 were 
twins. One of her sisters had 2 twin terras, 1 child surviving ; like her own 
children, all were females. A second sister had a twin term, both males, 
1 surviving. The other sister aborted female twins after a fall in the 
eighth month of pregnancy. The name of the patient was Mussamat Somni, 
and she was the wife of a respectable Indian carpenter. 

There are recorded the most wonderful accounts of prolificity, in which, 
by repeated multii)le births, a woman is said to have borne children almost 
beyond l^elief. A Xaples correspondent to a Paris Journal '^ gives the 
following: ''About 2 or 3 stations beyond Pompeii, in the City of Nocera, 
lives Maddalena Granata, aged forty-seven, who was married at twenty-eight, 
and has given birth to 52 living and dead children, 49 being males. Dr. de 
Sanctis, of Nocera, states that she has had triplets 15 times." 

Peasant Kirilow ^ was presented to the Empress of Russia in 1853, at the 
age of seventy years. He had been twice married, and his first Avife had 
presented him with 57 childi'en, the fruits of 21 pregnancies. She had quad- 
ruplets four times, triplets seven times, and twins thrice. By his second wdfe 
he had 15 children, twins six times, and triplets once. This man, accordingly, 
was the father of 72 children, and, to magnif}- the wonder, all the children 
were alive at the time of presentation. Herman, in some Russian statistics, '^ 
relates the instance of Fedor Vassilet, a peasant of the Moscow Jurisdiction, 
W'ho in 1872, at the age of seventy-five years, was the father of 87 children. 
He had been twice married ; his first wife bore him 69 children in 27 accouche- 
ments, having twins sixteen times, triplets seven times, and quadruplets four 
times, but never a single birth. His second wife bore him 18 children in 8 
accouchements. In 1872, 83 of the 87 children were living. The author 
says this case is beyond all question, as the Imperial Academy of St. 
Petersburg, as well as the French Academy, have substantial ])roof of it. 
The family are still living in Russia, and are the object of governmental 
favors. The following fact is interesting from the point of exaggeration, if 
for nothing else : " The New York Medical Journal is accredited Avitli 
publishing the following extract from tlie history of a journey to Saragossa, 
Barcelona, and Valencia, in the year 1585, by Philip II. of Spain. The 
book was written by Henrique Cock, who accompanied Philip as his private 
secretary. On page 248 the following statements are to l)e found : At the age 
of eleven years, INIargarita Goncalez, whose father w as a Biscayian, and whose 
mother was French, was married to her first husband, who was forty years 

a 540, June 1, 1894. b Quoted by 536. 1886, i., 57. 

c 476, 1857, ii., 259. d 476, 1878, i., 289. 


old. Bv him she had 78 boys and 7 girls. He died thirteen years after the 
marriage, and, after having remained a widow two years, the woman married 
again. By her second husband, Thomas Gchoa, she had 66 boys and 7 girls. 
These children were all born in Valencia, between the fifteenth and thirty- 
fifth vear of the mother's age, and at the time when the account was written 
she was thirtv-five years old and pregnant again. Of the children, 47 by the 
first husband and 52 bv the second were baptized ; the other births were still 
or premature. Tiiere were 33 confinements in all." 

Extreme Prolificity by Single Births. — The number of children a 
woman mav bring forth is therefore not to be accurately stated ; there seems 
to be almost no limit to it, and even when w^e exclude those cases in which 
remarkable multiplicity at each birth augments the number, there are still 
some almost incredible cases on record. The statistics of the St. Pancras Royal 
Dispensary, 1853, estimated the number of children one woman may bear as 
from 25 to 69. Eisenmenger relates the history of a case of a woman in the 
last centur>' bearing 51 children, and there is another case^ in which a woman 
bore 44 children, all boys. Atkinson ^ speaks of a lady married at sixteen, 
dying when she was sixty-four, who had borne 39 children, all at single births, 
by one husband, whom she survived. The children, 32 daughters and 7 sons, 
all attained their majority. There was a case of a woman in America^' who 
in twentv-six years gave birth to 22 children, all at single births. Thoresby 
in his " History of Leeds," 1715, mentions three remarkable cases — one the 
wife of Dr. Phineas Hudson, Chancellor of York, as having died in her 
thirtv-ninth year of her twenty-fourth child ; another of Mrs. Joseph Cooper, as 
dying of her twenty-sixth child, and, lastly, of Mrs. William Greenhill, of a 
village in Hertford, England, who gave birth to 39 children during her life. 
Brand, a writer of great repute, in his " History of Newcastle," quoted by 
Walford,^^^ mentions as a well attested fact the wife of a Scotch w^eaver 
who bore 62 children by one husband, all of whom lived to be baptized. 

A curious epitaph is to be seen at Conway, Carnarvonshire : — 

"Here lieth the body of Nicholas Hookes, of Conway, gentleman, who was 
one-and-fortieth child of his father, William Hookes, Esq., by Alice, his 
wife, and the ftither of 27 children. He died 20th of March, 1637." 

On November 21, 1768, Mrs. Shury, the wife of a cooper, in Vine 
Street, Westminster, was delivered of 2 boys, making 26 by the same hus- 
band. She had previously been confined with twins during the year. 

It would be the task of a mathematician to figure the possibilities of 
paternity in a man of extra long life who had married several prolific women 
during his prolonged period of virility. A man by the name of Pearsons 
of Lexton, Nottingham, at the time of the report had been married 4 times. 
By his first 3 wives he had 39 children and by his last 14, making a 

a 559, 1806, 1 B., 127. b 224, 1883, ii., 557. *= 218, Sept. 26, 1872. 


total of 53. He was 6 feet tall and lived to his ninety-sixth year. We have 
already mentioned the tMO Russian cases in which the paternity Avas 72 and 
87 children respectively, and in "Notes and Queries," June 21, 1856, there 
is an account of David Wilson of Madison, Ind., who had died a few years 
previously at the age of one hundred and seven. He had been 5 times mar- 
ried and was the father of 47 children, 35 of whom were living at the time 
of his death. 

On a tomb in Ely, Cambridgeshire, there is an inscription saying that 
Richard Worster, buried there, died on May 11, 1856, the tomb being in 
memory of his 22 sons and 5 daughters. 

Artaxerxes was supposed to have had 106 children ; Conrad, Duke of 
Moscow, 80 ; and in the polygamous countries the number seems incredible. 
Herotiuus was said " to have had 600 ; and Jc/Uston also quotes instances of 
225 and even of 650 in the Eastern countries. 

Recently there have been published accounts of the alleged experiments 
of Luigi Erba, an Italian gentleman of Perugia, whose results have been an- 
nounced. About forty years of age and being quite wealthy, this bizarre 
phihmthropist visited various quarters of the world, securing women of differ- 
ent races ; having secured a number sufficient for his purposes, he retired 
with them to Polynesia, where he is accredited with maintaining a unique 
establishment with his household of females. In 1896, just seven years after 
the experiment commenced, the reports say he is the father of 370 children. 

The following is a report from Raleigh, X. C, on July 28, 1893, to the 
New York Evening Post : — 

" The fecundity of the negro race has been the subject of much comment 
and discussion. A case has come to light in this State that is one of the 
most remarkable on record. Moses Williams, a negro farmer, lives in the 
eastern section of this State. He is sixty-five years old (as nearly as he can 
make out), but does not appear to be over fifty. He has been married twice, 
and by the two wives has had born to him 45 children. By the first wife he 
had 23 children, 20 of whom were girls and 3 were boys. By the second 
wife he had 22 children — 20 girls and 2 boys. He also has about 50 grand- 
children. The case is well authenticated." 

We also quote the following, accredited to the " Annals of Hygiene : " — 

" Were it not part of the records of the Berks County courts, Ave could 
hardly credit the history of John Heffner, who was accidentally killed some 
years ago at the age of sixty-nine. He was married first in 1 840. In eight years 
his wife bore him 17 children. The first and second years of their marriage 
she gave birth to twins. For four successive years afterward she gave birth 
to triplets. In the seventh year she gave birth to one child and died soon 
aftenvard. Heffner engaged a young woman to look after his large brood 
of babies, and three months later she became the second Mrs. Heffner. She 

a 447, 466. 


presented her husband with 2 ■ children in the first two years of her wedded 
life. Five years later she had added 10 more to the family, having twins 
5 times. Then for three years she added but 1 a year. At the time of the 
death of the second wife 12 of the 32 children had died. The 20 that were 
left did not appear to be any obstacle to a young widow with one child con- 
senting to become tlie third wife of the jolly little man, for he was known as 
one of the happiest and most genial of men, although it kept him toiling like 
a slave to keep a score of mouths in bread. The third Mrs. Heffner became 
the mother of 9 children in ten years, and the contentment and happiness of 
the couple were proverbial. One day, in the fall of 1885, the father of the 
41 children ^vas crossing a railroad track and was run down by a locomotive 
and instantly killed. His widow and 24 of the 42 children are still living." 

Many Marriages. — In this connection it seems appropriate to mention a 
few examples of multimarriages on record, to give an idea of the possibilities of 
the extent of paternity. St. Jerome mentions a widow who married her twenty- 
second husband, who in his time had taken to himself 20 loving spouses. 
A gentleman living in Bordeaux ^^^ in 1772 had been married 16 times. 
DeLongueville, a Frenchman, lived to be one hundred and ten years old, 
and had been joined in matrimony to 10 M'ives, his last wife bearing him a 
son in his one hundred and first year. 

Possible Descendants. — When we indulge ourselves as to the possible 
number of living descendants one person may have, we soon get extraordinary 
figures. The Madrid Estafette '^ states that a gentleman, Senor Lucas Xe- 
(pieiras Saez, who emigrated to America seventy years previously, recently 
returned to Spain in his own steamer, and brought with him his whole family, 
consisting of 197 persons. He had been thrice married, and by his first 
wife had 11 children at 7 births; by his second wife, 19 at 13 births, and by 
his third wife, 7 at 6 births. The youngest of the 37 was thirteen years 
old and the eldest seventy. This latter one had a son aged forty-seven and 
16 children besides. He had 34 granddaughters, 45 grandsons, 45 great 
granddaughters, 39 great grandsons, all living. Seiior Saez himself was 
ninety-three years old and in excellent health. 

At Litchfield, Conn., there is said to be the following inscription : ^^' — 

" Here lies tlie body uf Mrs. Mary, wife of Dr. John Bull, Esq. She died 
November 4, 1778, aetat. ninety, having had 13 children, 101 grandchil- 
dren, 274 great grandchildren, and 22 great-great grandchildren, a total 
of 410; surviving. 336." 

In Esher Church there is an inscription, .scarcely legible, which records 
the death of the mother of Mrs. Mary Morton on April 18, 1634, and saying 
that she was the wonder of her sex and age, for she lived to see nearly 
400 issued from her loins. 

a 224, 1883, ii., 207. 


The following is a communication to " Notes and Queries," March 21, 
1891 : '' Mrs. Mary Honey wood was daughter and one of the coheiresses of 
Robert Waters, Esq., of Lenhani, in Kent. She was born in 1527 ; married 
in February, 1543, at sixteen years of age, to her only husband, Robert 
Honey wood, Esq., of Charing, in Kent. She died in the ninety-third 
year of her age, in May, 1620. She had 16 children of her own body, 7 
sons and 9 daughters, of whom one had no issue, 3 died young — the young- 
est was slain at Newport battle, June 20, 1600. Her grandchildren, in the 
second generation, were 114 ; in the third, 228, and in the fourth, 9 ; so that 
she could almost say the same as the distich doth of one of the Dalburg 
family of Basil : ' Rise up, daughter and go to thy daughter, for thy daugh- 
ter's daughter hath a daughter.' 

'' In Markshal Church, in Essex, on Mrs. Honeywood's tomb is the follow- 
ing inscription : ' Here lieth the body of Mary Waters, the daughter and co- 
heir of Robert Waters, of Lenham, in Kent, wife of Robert Honeywood, of 
Charing, in Kent, her only husband, wdio had at her decease, lawfully de- 
scended from her, 367 children, 16 of her own body, 114 grandchildren, 228 
in the third generation, and 9 in the fourth. She lived a most pious life and 
died at Markshal, in the ninety-third year of her age and the forty-fourth 
of her Ayidowhood, May 11, 1620.' (From 'Curiosities for the Ingenious,* 
1825.) ' S. S. R." 

Animal proliiicity, though not finding a place in this work, presents 
some wonderful anomalies.^ 

a In illustration we may nota the following: In the Illustrated London News, May 11, 
1895, is a portrait of "Lady Millard," a fine St. Bernard bitch, the property of Mr, Thorp 
of Northwold, with her litter of 21 puppies, born on February 9, 1895, their sire being a 
magnificent dog — "Young York." There is quoted an incredible account^ of a cow, the 
property of J. N. Sawyer of Ohio, which gave birth to 56 calves, one of which was fully 
matured and lived, the others being about the size of kittens ; these died, together with the 
mother. There was a cow in France, in 1871, delivered of 5 calves. 

1 609, 1879, i., 525. 


Monstrosities have attracted notice from the earliest time, and many 
of the ancient philosoj)hers made references to them. In mythology we 
read of Centaurs, impossible beings who had the body and extremities of a 
beast ; the Cyclops, possessed of one enormous eye ; or their parallels in 
Egyptian myths, the men with pectoral eyes, — the creatures " whose heads 
do beneath their shoulders grow ;" and the Fauns, those sylvan deities whose 
lower extremities bore resemblance to those of a goat. Monsters possessed 
of two or more heads or double bodies are found in the legends and fairy 
tales of every nation, Hippocrates, his precursors, Empedocles and Demo- 
critus, and Pliny, Aristotle, and Galen, have all described monsters, although 
in extravagant and ridiculous language. 

Ballantyne remarks that the occasional occurrence of double monsters Avas 
a fact known to the Hip])()cratic school, and is indicated by a passage in I)e 
morbis muliebributi, in which it is said that labor is gravely interfered with 
when the infant is dead or apoplectic or double. There is also a reference 
to monochorionic twins (which are by modern teratologists regarded as mon- 
strosities) in the treatise De Superfcetatione, in which it is stated that " a woman, 
pregnant with twins, gives birth to them both at the same time, just as she 
has conceived them ; the two infants are in a single chorion." 

Ancient Explanations of Monstrosities. — From the time of Galen to 
the sixteenth century many incredible reports of monsters are seen in medical 
literature, but without a semblance of scientific truth. There has been little 
improvement in the mode of explanation of monstrous births until the present 
century, while in the Middle Ages the superstitions were more ludicrous and 
observers more ignorant than before the time of Galen. In his able article 
on the teratologic records of Chaldea, Ballantyne^ makes the following trite 
statements : " Credulity and superstition have never been the peculiar pos- 
session of the lower types of civilization only, and the special beliefs that have 
gathered round the occurrence of teratologic phenomena have been common 
to the cultured Greek and Roman of the past, the ignorant peasant of modern 
times, and the savage tribes of all ages. Classical writings, the literature of 
the Middle Ages, and the popular beliefs of the present day all contain views 

a 759, 1894, 130. 
11 161 



concerning teratologic subjects which so closely resemble those of the Chal- 
dean magi as to be indistinguishable from them. Indeed, such works as 
those of Obsequens, Lycosthenes, Licetus, and Ambroise Pare only repeat, 
but Avith less accuracy of description and with greater freedom of imagina- 
tion, the beliefs of ancient Babylon. Even at the present time the most 
impossible cases of so-called ' maternal impressions ' are widely scattered 
through medical literature ; and it is not xary long since I received a letter 
from a distinguished member of the profession asking me whether, in my 
opinion, I thought it possible for a woman to give birth to a dog. Of course, 
I do not at all mean to infer that teratology has not made immense advances 
within recent times, nor do I suggest that on such subjects the knowledge of 
the magi can be compared with that of the average medical student of the 

present ; but what I wish to emphasize is 
that, in the literature of ancient Babylonia, 
there are indications of an acquaintance 
with structural defects and malformations 
of the human body which will compare 
favorably with even the writings of the 
sixteenth century of the Christian era." 

Many reasons were given for the exist- 
en(!e of monsters, and in the Middle Ages 
these were as faulty as the descriptions 
themselves. They were interpreted as divi- 
nations, and were cited as forebodings and 
examples of wrath, or even as glorifica- 
tions of the Almighty. The semi-human 
creatures were invented or imagined, and 
cited as the results of bestiality and allied 
forms of sexual perversion prevalent in 
those times. AVe find minute descriptions 
and portraits of these impossible results of wicked practices in many of the 
older medical books. According to Pare^ there was born in 1493, as the 
result of illicit intercourse betMcen a woman and a dog, a creature resembling 
in its upper extremities its mother, while its lower extremities were the exact 
counterpart of its canine father (Fig. 24). This particular case was believed 
bv Bateman and others to be a precursor to the murders and wickedness that 
followed in the time of Pope Alexander I. Yolateranus, Cardani, and 
many others cite instances of this kind. Lycosthenes says that in the year 
1110, in the bourg of Liege, there was found a creature with the head, visage, 
hands, and feet of a man, and the rest of the body like that of a pig. Pare 
quotes this case and gives an illustration. Rhodiginus'' mentions a shepherd 
of Cybare by the name of Cratain, who had connection with a female goat and 
a 618, 1031. ^ 679, L. xxv., cliap. 32. 

Fig. •i-1.— Dog-boT (after Par6). 


impregnated her, so that she brought forth a beast with a head resembling 
that of the father, but with the lower extremities of a goat. He says that the 
likeness to the father was so marked that the head-goat of the herd recog- 
nized it, and accordingly slew the goatherd who had sinned so unnaturally. 
In the year 1547, at Cracovia,^^^ a very strange monster was born, which 
lived three days. It had a head shaped like that of a man ; a nose long 
and hooked like an elephant's trunk ; the hands and feet looking like the 
web-foot of a goose ; and a tail with a hook on it. It was supposed to be a 
male, and was looked upon as a result of sodomy. KuefF'^ says that the pro- 
creation of human beings and beasts is brought about — 

(1) By the natural appetite ; 

(2) By the provocation of nature by delight ; 

(3) By the attractive virtue of the matrix, which in beasts and women is 

Plutarch, in his " Lesser Parallels," says that Aristonymus Ephesius, son 
of Demonstratus, being tired of women, had carnal knowledge with an ass, 
which in the process of time brought forth a very beautiful child, who 
became the maid Onoseelin. He also speaks of the origin of the maiden 
Hippona, or as he calls her, Hippo, as being from the connection of a man 
with a mare. Aristotle mentions this in his paradoxes, and we know that 
the patron of horses was Hippona. In Helvetia ^^^ was reported the exist- 
ence of a colt (whose mother had been covered by a bull) that was half horse 
and half bull. One of the kings of France was supposed to have been 
presented with a colt with the hinder part of a hart, and which could out- 
run any horse in the kingdom. Its mother had been covered by a hart. 

Writing in 1557, Lycosthenes reports the mythical birth of a serpent by 
a woman. It is quite possible that some known and classified type of 
monstrosity was indicated here in vague terms. In 1726 Mary Toft, of 
Godalming, in Surrey, England, achieved considerable notoriety throughout 
Surrey, and even over all England, by her extensively circulated statements 
that she bore rabbits. Even at so late a day as this the credulity of the 
peo[)le was so great that many persons believed in her. The woman was 
closely watched, and being detected in her maneuvers confessed her fraud. 
To show the extent of discussion this case called forth, there are no less 
than nine pamphlets and books in the Surgeon-General's library at Wash- 
ington devoted exclusively to this case of pretended rabbit-breeding. 
Hamilton in 1848, and Hard'' in 1884, l)oth report the births in this 
country of fetal monstrosities with heads which showed marked resemblance 
to those of dogs. Doubtless many of the older cases of the supposed results 
of bestiality, if seen to-day, could be readily classified among some of our 
known forms of monsters. Modern investigation has shown us the sterile 
results of the connections between man and beast or between beasts of 

a "The Expert Midwife," London, 1637. b 269, xlviii., 246. 



different species, and we can only wonder at the simple credulity and the 
imaginative minds ot" our ancestors. At one period certain phenomena of 
nature, such as an eclipse or comet, were thought to exercise their influence 
on monstrous births, llueff mentions that in Sicily there happened a great 
eclipse of the sun, and that women immediately began to bring forth 
deformed and doul)le-headed children. 

Before ending these preliminary remarks, there might be mentioned the 
marine monsters, such as mermaids, sea-serpents, and the like, which 
from time to time have been reported ; even at the present day there are 
people who devoutly believe that they have seen horrible and impossible 

demons in the sea. Pare* describes and 
pictures a monster, at Rome, on Novem- 
ber 3, 1520, with the upper portion of a 
child apparently about five or six years 
old, and the lower part and ears of a fish- 
like animal. He also pictures a sea- 
devil in the same chapter, together with 
other gruesome examples of the power 
of imagination. 

Early Teratology. — Besides such 
cases as the foregoing, Ave find the medi- 
eval writers report likely instances of 
terata, as, for instance, Rhodiginus, ^''^ 
who speaks of a monster in Italy with 
two heads and two bodies ; Lycosthenes 
saw a double monster, both components 
of which slept at the same time ; he also 
says this creature took its food and drink 
simultaneously in its two mouths. Even 
Saint Augustine says that he knew of a 
child born in the Orient Avho, from the 
belly up, was in all parts double. 
The first evidences of a step toward classification and definite reasoning 
in regard to the causation of monstrosities were evinced by Ambroise Pare 
in the sixteenth century, and though his ideas are crude and some of his 
phenomena impossible, yet many of his facts and arguments are worthy of 
consideration. Pare attributed the cause of anomalies pf excess to an 
excessive quantity of semen, and anomalies of defiiult to deficiency of the 
same fluid. He has collected many instances of double terata from reliable 
sources, but has interspersed his collection with accounts of some hideous 
and impossible creatures, such as are illustrated in the accompanying figure 
(Fig. 25), which shows a creature that was born shortly after a battle of 

a 618, 1053. 

Fig. 25.— Bird-boy (after Par6j. 



Louis XII., in \')V2 ; it had the wings, crest, and lower extremity of a bird 
and a human liead and trunk ; l)esides, it was an hermaplirodite, and had an 
extra eye in the knee. Another illustration represents a monstrous head 
found in an egg, said to hav'je been sent for examination to King Charles at 
Metz in 1569. It represented the face and visage of a man, with small 
living serpents taking the place of beard and hair. So credulous were people 
at this time that even a man so well informed as Pare believed in the pos- 
sibility of these last two, or at least represented them as facts. At this time 
were also reported double hermaphroditic terata, seemingly without latter- 
day analogues. liliodiginus •' speaks of a two-headed monster born in Ferrari, 
Italy, in 1540, well formed, and with two sets of genitals, one male and the 

Fig. 26. — Bicephalic and heiniaphroditic 
monster (after Par6). 

Fig. 27. — Double hermaphroditic monster (after 


other female (Fig. 26), Pare'' gives a picture (Fig. 27) of twins, born near 
Heidelberg in 1486, which had double bodies joined back to back ; one of 
the twins had the aspect of a female and the other of a male, though both 
had two sets of genitals. 

Scientific Teratology. — Al>out the first half of the eighteenth century 
what might be called the positive period of teratology begins. Following 
the advent of this era come Mery, Duverney, Winslow, Lemery, and Littre. 
In their works true and concise descriptions are given and violent attacks are 
made against the ancient beliefs and prejudices. From the beginning of the 
second half of the last century to the present time may be termed the scien- 
tific epoch of teratology. AVe can almost wuth a certainty start this era wdth 

a 679, L. xxiv., chap. 30. ^ 618, 1016. 



the names of Haller, Morgagui, GeofFroy-Saint-Hilaire, and Meckel, who 
adduced the explanations asked for by Harvey and Wolff. From the 
appearance of the treatise by Geoffroy-Saint-Hilaire, teratology has made 
enormous strides, and is to-day well on the road to becoming a science. 
Hand in hand with embryology it has been the subject of much investiga- 
tion in this century, and to enumerate the workers of the present day who 
have helped to bring about scientific progress would be a task of many pages. 
Even in the artificial production of monsters much has been done, and a 
glance at the work of Dareste ^ well repays the trouble. Essays on terato- 
genesis, witli reference to batrachians, have been offered by Lombardini ; 
and by Lereboullet and Knoch with reference to fishes. Foil and AVarynski '' 
have reported their success in obtaining visceral inversion, and even this 
branch of the subject promises to become scientific. 

Terata are seen in the lower animals and always excite interest. 
Pare '^ gives the history of a sheep with three heads, born in 1577; the 

central head was larger than the other 
two, as shown in the accompanying 
illustration (Fig. 28). Many of the 
Museums of Xatural History contain 
evidences of animal terata. At Hallse 
is a two-headed mouse ; the Conant 
Museum in !Maine contains the skele- 
ton of an adult sheep with two heads ; 
there was an account of a two-headed 
pigeon published in France in 1 734 ; *^ 
Leidy found a two-headed snake in a 
field near Philadelphia ; Geoffroy- 
Saint-Hilaire and Conant both found similar creatures, and there is one in 
the Museum at Harvard ; AVvman saw a living double-headed snake in the 
Jardin des Plantes in Paris in 1853, and many parallel instances are on 

Classification. — AVe shall attempt no scientific discussion of the causa- 
tion or embryologic derivation of the monster, contenting ourselves with 
simple history and description, adding any associate fiicts of interest that may 
be suggested. For further infitrmation, the reader is referred to the authors 
cited or to any of the standard treatises on teratology. 

Many classifications of terata have been offered, and each- possesses some 
advantage. The modern reader is referred to the modification of the group- 
ing of Geoffroy-Saint-Hilaire given by Hirst and Piersol^^', or those of 
Blanc -'- and Guinard •^^-'. For convenience, we have adopted the following 
classification, which will include onlv those monsters that have lived after 

^ Recherches sur la production artificielle des nionstruosites, etc., Paris, 1894, 8". 

b Eecueil zoologique Suisse, 1883. *= 618, 1034. '^ Slemoires de I'Acad. des Sciences. 

Fig. 28. — Three-headed sheep (after Pare). 



























birth, and who have attracted general notice or attained some fame in their 
time, as attested by accounts in contemporary literature. 

-Union of several fetuses. 

-Union of two distinct fetuses by a connecting band. 

-Union of two distinct fetuses by an osseous junction of the cranial bones. 

-Union of two distinct fetuses in which one or more parts are eliminated by the 

-Fusion of two fetuses by a bony union of the ischii. 

-Fusion of two fetuses below the umbilicus into a common lower extremity. 
-Bicephalic monsters. 
-Parasitic monsters. 

-Monsters with a single body and double lower extremities. 
-Diphallic terata. 

-Fetus in fetu, and dermoid cj'sts. 

Class I. — Triple Monsters. — Haller and Meckel were of the opinion 
that no cases of triple monsters worthy of credence are on record, and since 
their time this has been the popular opinion. 
Surely none have ever lived. Licetus"*^^ 
describes a human monster with two feet and 
seven heads and as many arms. Bartho- 
linus ^ speaks of a three-headed monster who 
after birth gave vent to horrible cries and 
expired. Borellus ^^^ speaks of a three- 
headed dog, a veritable Cerberus. Blasius -^"' 
published an essay on triple monsters in 
1677. Bordenave '^ is ([uoted as mention- 
ing a human monster formed of three fetuses, 
but his description proves clearly that it was 
only the union of two. Probably the best 
example of this anomaly that we have was 
described by Galvagni at Cattania in 1834. 
This monster had two necks, on one of which 
was a single head normal in dimensions. On 
the other neck were two heads, as seen in the 
accompanying illustration (Fig. 29). Geotfroy-Saint-Hilaire mentions several 
cases, and Martin de Pedro publishes a description of a case in Madrid in 
1879. There are also on record some cases of triple monster by inclusion 
which will be spoken of later. Instances in the lower animals have been 
seen, the three-headed sheep of Pare, already sj^oken of, being one. 

Class II. — Double Monsters. — A curious mode of junction, probably 
the most interesting, as it admits of longer life in these monstrosities, is that 
of a simple cartilaginous band extending between two absolutely distinct and 

a 190, cent, vi., obs. 49, 278. b 302, xxxiv., 158. 

Fig. 29. —Three-headed monster (Galvagni). 



different individuals. The band is generally in the sternal region. In 
1752 '^""^ there was described a remarkable monstrosity which consisted of 
conjoined twins, a perfect and an imperfect child, connected at their ensiform 
cartilages by a band 4 inches in circumference. The Hindoo sisters, de- 
scribed by Dr. Andrew Berry,'' lived to be seven years old ; they stood face to 
face, with their chests 6| inches and their pubes 8| inches apart. Mitchell ^ 
describes the full-grown female twins, born at Newport, Ky., called the New- 
port twins. The Avoman who gave birth to them became impregnated, it 
is said, immediately after seeing the famous Siamese twins, and the products 
of this pregnancy took the conformation of those celebrated exhil)iti()nists. 

Perhaps the best known of all 
double monsters were the Siamese 
twins. They were exhibited all 
over the globe and had the additional 
benefit and advertisement of a much- 
mooted discussion as to the advis- 
ability of their severance, in which 
opinions of the leading medical men 
of all nations were advanced. The 
literature on these famous brothers 
is simply stupendous. The amount 
of material in the Surgeon-General's 
library at Washington would sur- 
prise an investigator. A curious 
volume in this library is a book con- 
taining clippings, advertisements, and 
divers portraits of the twins. It will 
be impossible to speak at all fully on 
tliis sul)iect, but a short history and 
running review of their lives will be 
given : Eng and Chang were born in 
Siam about May, 1811. Their father 
was of Chinese extraction and had gone to Siam and there married a woman 
whose father was also a Chinaman. Hence, for the most part, they were of 
Chinese blood, which probably accounted for their dark color and Chinese 
features. Their mother was al)out thirty-five years old at the time of their 
birth and had borne 4 female children prior to Chang ajid Eng. She 
afterward had twins several times, having eventually 14 children in all. 
She gave no history of special significance of the pregnancy, although she 
averred that the head of one and the feet of the other were born at the same 
time. The twins were both feeV)le at birth, and Eng continued delicate, 
while Chang thrived. It was only with difficulty that their lives were saved, 
a 776, 1821. t> 818, 1832. 

Fig. 30.— Siamese twins at eighteen years of age. 



as Chowpahvi, the reigning king, had a superstition that such freaks of nature 
always presaged evil to the country. They were really discovered by Robert 
Hunter, a British merchant at Bangkok, who in 1824 saw them boating 
and stripped to tlie waist. He prevailed on the parents and King Chow- 
pahyi to allow them to go away for exhibition. They were first taken out 
of the country by a certain Captain Coffin. The first scientific descrip- 
tion of them was given by Professor J. C. AVarren, who examined them 
in Boston, at the Harvard University, in 1829. At that time Eng was 
•5 feet 2 inches and Chang 5 feet 1| inches in height. They presented all 

Fig. 31. — Siamese twins in old age. 

the characteristics of Chinamen and wore long black queues coiled thrice 
around their heads, as shown by the accompanying illustration (Fig. 30). 
After an eight-weeks' tour over the Eastern States they went to London, arriv- 
ing at that port November 20, 1829. Their tour in France was forbidden 
on the same grounds as the objection to the exhibition of Ritta-Christina, 
namely, the possibility of causing the production of monsters by maternal 
impressions in pregnant women. After their European tour they returned 
to the United States and settled down as farmers in Xorth Carolina, adopt- 
ing the name of Bunker. When forty-four years of age they married two sis- 



ters, Englisli women, twenty-six and twenty-eight years of age, respectively. 
Domestic infelicity soon compelled them to keep the wives at dilFerent houses, 
and they alternated weeks in visiting each wife. Chang had six children and 
Eng five, all healthy and strong. In 1869 they made another trip to Europe, 
ostensibly to consult the most celebrated surgeons of Great Britain and 
France on the advisability of being separated. It was stated that a feeling 
of antagonistic hatred after a quarrel })rompted them to seek " surgical sepa- 
ration," but the real cause was most likely to replenish their depleted 
exchequer by renewed exhibition and advertisement. 

A most pathetic characteristic of these illustrious brothers was the affec- 
tion and forbearance they showed for each other until shortly before their 

death. They bore each other's 
trials and petty maladies with the 
greatest sympathy, and in this 
manner rendered their lives far 
more agreeable than a casual 
observer would suppose possible. 
They both became Christians and 
members or attendants of the 
Baptist Church. 

Figure 31 is a representation 
of the Siamese t;^vins in old age. 
On each side of them is a son. 
The original photograph is in the 
Mutter Museum, College of Phy- 
sicians, Philadelphia. 

The feasibility of the operation 
of separating them was discussed 
by many of the leading men of 
America, and Thompson, Fergus- 
son, Syme, Sir J. Y. Simpson, 
Xt'laton, and many others in Eu- 
rope, with various reports and opinions after examination. These opinions 
can be seen in full in nearly any large medical library. At this time they 
had diseased and atheromatous arteries, and Chang, who was quite intem- 
perate, had marked spinal curvature, and shortly afterward became hemi- 
plegic. They were both partially blind in their t\vo antedor eyes, possibly 
from looking outward and obliquely. The point of junction was about the 
sterno-xiphoid angle, a cartilaginous band extending from sternum to 
sternum. In 1869 Simpson measured this band and made the distance on 
the superior aspect from sternum to sternum A^ inches, though it is most 
likely that during the early period of exhibition it was not over 3 inches. 
The illustration shows very well the position of the joining band (Fig. 32). 

Fig. 32. — Diagram from a cast showing the position of 
the ligament and of the primary anterior incisions. Dur- 
ing life the twins never assumed the face-to-face position 
in which they are here represented, and which is without 
doubt that of their fetal life. 



The twins died on Januarv 17, 1874, and a committee of surgeons from 
the College of Physicians of Philadelpliia, consisting of Doctors Andrews, 
Allen, and Pancoast, went to North Carolina to perform an autopsy on the 
body, and, if possible, to secure it. They made a long and most interesting 
report on the results of their trip to the College. The arteries, as was 
anticipated, were found to have undergone calcareous degeneration. There 
was an hepatic connection through the band, and also some interlacing 
diaphragmatic fibers therein. There was slight vascular intercommunica- 
tion of the livers and- independence of the two peritoneal cavities and the 
intestines (Fig. 33). The band itself was chiefly a coalescence of the xyphoid 
cartilages, surrounded by areolar tissue and skin (Fig. 34). 

The " Orissa sisters," or Radica-Doddica, shown in Europe in 1893, 
were similar to tne ISiamese twins in conformation. They were born in 

Fig. 33. — Diagrammatic i-epreseutation of the 
livers, portraying tlie relatijous of the vas.sels, etc. 
The arrows show the direction in which an injection 
passed from Chang to Eng. 



Fig. 34. — Diagrammatic representation of the 
band. A, upper or hepatic pouch of Chang; E, E 
^dotted line), union of the ensiform cartilages ; />, 
connecting liver band, or the "tract of portal con- 
tinuity;" B, the peritoneal pouch of Eng; C, the 
lower peritoneal pouch of Chang ; F, F, lower bor- 
der of the baud. 

Orissa, India, September, 1889, and were the result of the sixth pregnancy, 
the other five being normal. They were healthy girls, four years of age, and 
apparently perfect in every respect, except that, from the ensiform cartilage 
to the umbilicus, they were united by a band 4 inches long and 2 inches 
wide (Fig. 35). The children when facing each other could draw" their 
chests three or four inches apart, and the band was so flexible that they could 
sit on either side of the body. Up to the date mentioned it was not known 
whether the connecting band contained viscera. A portrait of these twins 
was shown at the World's Fair in Chicago. 

In the village of Arasoor, district of Bhavany, there was reported a mon- 
strosity in the form of two female children, one 34 inches and the other 
33| inches high, connected by the sternum. They were said to have had 
small-pox and to have recovered. They seemed to have had individual ner- 
vous systems, as when one was pinched the other did not feel it, and while one 
slept the other was awake. There must have been some vascular connection, 
as medicine given to one aflPected both. 



Fig. 36 shows a mode of cartilagiiKtus junction by which each component 
of a double monster may be virtually independent. 

Operations on Conjoined Twins. — Swingler =' speaks of two girls joined 
at the xiphoid cartilage and the umbilicus, the band of union Ijeing 1 J inches 
thick, and running below the middle of it was the umbilical cord, common to 
both. They first ligated the cord, which fell off in nine days, and then sepa- 
rated the twins with the bistoury. They each made early recovery and lived. 

In the Ephemerides of 1690 Konig gives a description of two Swiss 
sisters born in 1689 and united belly to belly, who were separated by means 

Fig. 35. — Radica-Doddica, the " Orissa .Sister-s." 

Fig. 36.— Skeleton showing a mode of junction 
of independent double monsters. 

of a ligature and the operation afterward completed by an instrument. The 
constricting band was formed by a coalition of the xiphoid cartilages and the 
umbilical vessels, surrounded by areolar tissue and covered with skin. Le 
Beau ^ says that under the Roman reign, A. D. 945, two male children were 
brought from Armenia to Constantinople for exhibition. They were well 
formed in every respect and united l)y their abdomens. After they had l)een 
for some time an object of great curiosity, they were removed by governmen- 
tal order, being considered a presage of evil. They returned, however, at 
a Quoted 302, vol. xxxiv. b Histoire du Bas-Eiupire, 1776. 



the commencement of the reign of Constantine A^II., when one of them took 
sick and died. The surgeons undertook to preserve the other by separating 
him from the corpse of his brother, but he died on the third day after the 

In 1866 Boehm^ gives an account of Guzenhausen's case of twins who 
were united sternum to sternum. An operation for se})aration was per- 
formed without accident, but one of the children, already very feeble, 
died three days alter ; the other survived. The last attempt at an oper- 
ation like this was in 1881, when Biaudet and Buginon attempted to 
separate conjoined sisters (Marie- Adele) born in Switzerland on June 26th. 
Unhappily, they were very feeble and life was despaired of when the opera- 
tion was performed, on October 29th. Adele died six hours afterward, and 
Marie died of peritonitis on the next day. 

Class III. — Those monsters joined by a 
fusion of some of the cranial bones are some- 
times called craniopagi. A very ancient obser- 
vation of this kind is cited by GeoflProy-Saint- 
Hilaire. These two girls were born in 1495, and 
lived to be ten years old. They were normal in 
every respect, except that they were joined at the 
forehead, causing them to stand face to face and 
belly to belly (Fig. 37). When one walked for- 
ward, the other was compelled to walk backward ; 
their noses almost touched, and their eyes were 
directed laterally. At the death of one an attempt 
to separate the other from the cadaver was made, 
but it was unsuccessful, the second soon dying ; 
the operation necessitated opening the cranium 
and parting the meninges. Bateman '^^ said that in 1501 there was living 
an instance of double female twins, joined at the forehead. This case was 
said to have been caused in the following manner : Two women, one of 
whom was pregnant with the twins at the time, were engaged in an earnest 
conversation, when a third, coming up behind them, knocked their heads 
together with a sharp blow. Bateman describes the death of one of the 
twins and its excision from the other, who died subsequently, evidently of 
septic infection. There is a possibility that this is merely a duplication of the 
account of the preceding case with a slight anachronism as to the time of 

At a foundling hospital in St. Petersburg '' there were born two living 
girls, in good health, joined by the heads. They were so united that the nose 
of one, if prolonged, would strike the ear of the other ; they had perfectly 
independent existences, but their vascular systems had evident connection. 

a 161, 1866, 152. b 573^ July, 1855. 

Fig. 37.— Crauiopagus (after Par6). 



Through extra mobility of their necks they couki really lie in a straight line, 
one sleeping on the side and the other on the back. There is a report " of 
two girls joined at their vertices, who survived their birth. AVith the excep- 
tion of this junction they were well formed and inde})endent in existence. 
There Avas no communication of the cranial cavities, but simply fusion of the 
cranial bones covered by superficial fascia and skin (Fig. 38). Daubenton 
has seen a case of union at the occiput,*^ but further details are not 

Class IV. — The next class to be considered is that in which the indi- 
viduals are separate and well formed, except that the point of fusion is a 
common part, eliminating their individual componeuts in this location. 
The pygopagous twins belong in this section. According to Bateman,^^^ 
twins were born in 1493 at Rome joined back to back, and survived their birth. 
The same authority speaks of a female child who v/as born with " 2 bellies, 

4 arms, 4 legs, 2 heads, and 2 sets of privates, and 
was exhibited throughout Italy for gain's sake." 
The " Biddenden Maids " were born in Bidden- 
den, Kent, in 11 00.*^ Their names were Mary 
and Eliza Chulkhurst, and their parents were 
fairly well-to-do people. They were supposed to 
have been united at the hips and the shoulders, and 
lived until 1134. At the death of one it was 
proposed to separate them, but the remaining 
sister refused, saying, "As we came together, we 
will also go together," and, after about six hours 
of this Mezentian existence, they died. They 
bequeathed to the church- wardens of the parish 
and their successors land to the extent of 20 acres, 
at the present time bringing a rental of about 
$155.00 annually, with the instructions that the 
money was to be spent in the distribution of cakes 
(bearing the impression of their images, to be given 
away on each Easter Sunday to all strangers in 
Biddenden) and also 270 quartern loaves, with cheese in proportion, to all 
the poor in said parish. Ballantyne has accompanied his description of 
these sisters by illustrations, one of ^^•hich shows the cake (Fig. 39). 
Heaton ^ gives a very good description of these maids ; and a writer in 
"Notes and Queries" of March 27, 1875, gives the following information 
relative to the bequest : — 

" On Easter Monday, at Biddenden, near Sta]ilehurst, Kent, there is a 
distribution, according to ancient custom, of ' Biddenden ]\Iaids' cakes,' with 
bread and cheese, the cost of which is defrayed from the proceeds of some 
a 212, 259. ^ 302, xxxiv. c 759, Oct., 1895. ^ 224, 1869, i., 363. 

Fig. 38. — Twins joined at forehead. 



20 acres of land, now yielding £35 per annum, and known as the ' Bread 
and Cheese Lands.' About the year 1100 there lived Eliza and Mary Chulkr 
hurst, who were joined together after the manner of the Siamese twins, and 
who lived for thirty-f<Kir years, one dying, and then being followed by her 
sister within six hours. They left by their will the lands above alluded to, 
and their memory is perpetuated by imprinting on the cakes their effigies ' in 
their habit as they lived.' The cakes, which are simple flour and water, are 
four inches long by two inches wide, and are much sought after as curiosi- 
ties. These, which are given away, are distributed at the discretion of the 
church-wardens, and are nearly 300 in number. The bread and cheese 
amounts to 540 quartern loaves and 470 pounds of cheese. The distribu- 
tion is made on land belonging to the charity, known as the Old Poorhouse. 
Formerly it used to take place in the 
Church, immediately after the service 
in the afternoon, but in consequence of 
the unseemly disturbance which used to 
ensue the practice was discontinued. 
The Church used to be filled with a 
conffretyation whose conduct was occa- 
sionally so reprehensible that some- 
times the church-wardens had to use 
their wands for other purposes than sym- 
bols of office. The impressions of the 
' maids ' on the cakes are of a primitive 
character, and are made by boxwood 
dies cut in 1814. They bear the date 
1100, when Eliza and Mary Chulkhurst 
are supposed to have been born, and also 
their age at death, thirty-four years." 

Ballantyne ''■^^ has summed up about 
all there is to be said on this national 
monstrosity, and his discussion of the 
case from its historic as well as tera- 
tologic standpoint is so excellent that 
his conclusions will be quoted : — 

" It may be urged that the date fixed for the birth of the Biddenden 
Maids is so remote as to throw grave doubt upon the reality of the occur- 
rence. The year 1100 was, it will be remembered, that in which William 
Rufus was found dead in the New Forest, ' with the arrow either of a hunter 
or an assassin in his breast.' According to the Anglo-Saxon Chronicle, sev- 
eral ' prodigies ' preceded the death of this profligate and extravagant mon- 
arch. Thus it is recorded that ' at Pentecost blood was observed gushing 
from the earth at a certain town of Berkshire, even as many asserted who 

l"ig. 39.— Bidiluudcu JIaids' cake (Ballantyne). 


declared that they had seen it. And after this, on the morning after Lam- 
mas Day, King William Avas shot.' Xow, it is jnst possible that the birth 
of the Biddenden Maids may have occnrred later, but have been antedated 
by the popular tradition to the year above mentioned. For such a birth 
would, in the opinion of the times, be regarded undoubtedly as a most evi- 
dent prodigy or omen of evil. Still, even admitting that the date 1100 must 
be allowed to stand, its remoteness from the present time is not a convincing 
argument against a belief in the real occurrence of the phenomenon ; for of 
the dicephalic Scottish brothers, who lived in 1490, we have credible historic 
evidence. Further, Lycosthenes, in his " Chronicon Prodigiorum atque 
Ostentorum" (p. 397), published in 1557, states, upon what authority I know 
not, that in the year 1112 joined twins resembling the Biddenden phenom- 
enon in all points save in sex were born in England. The passage is as fol- 
lows : ' In Anglia natus est puer geminus a clune ad superiores partes ita 
divisus, ut duo haberet capita, duo corpora Integra ad renes cum suis brachiis, 
qui baptizatus triduo supervixit.' It is just possible that in some way or 
other this case has been confounded with the story of Biddenden ; at any rate, 
the occurrence of such a statement in Lycosthenes' work is of more than pass- 
ing interest. Had there been no bequest of land in connection with the case 
of the Kentish Maids, the whole atfair would probably soon have been for- 
gotten. • 

" There is, however, one real difficulty in accepting the story handed down 
to us as authentic, — the nature of the teratologic phenomenon itself. All 
the records agree in stating that the ]Maids were joined together at the 
shoulders and hips, and the impression on the cakes and the pictures on the 
'broadsides' show this peculiar mode of union, and represent the bodies as 
quite separate in the space l)etween the above-named points. The Maids 
are shown with four feet and two arras, the right and left respectively, whilst 
the other arms (left and right) are fused together at the shoulder accord- 
ing to one illustration, and a little above the elbow according to another. 
Now, although it is not safe to say that such an anomaly is impossible, I do 
not know of any case of this peculiar mode of union ; but it may be that^ 
as Prof. A. R. Simpson has suggested, the Maids had four separate arms, 
and were in the habit of going about with their contiguous arms round each 
other's necks, and that this gave rise to the notion that these limbs were 
united. If this be so, then the teratologic difficulty is removed, for the 
case becomes perfectly comparable with the well-known but rare type of 
double terata known as the pygopagous twins, Avhich is placed by Taruffi 
with that of the ischiopagous twins in the group dicephalus lecanopagus. 
Similar instances, which are well known to students of teratology, are the 
Hungarian sisters (Helen and Judith), the North Carolina twins (Millie and 
Christine), and the Bohemian twins (Rosalie and Josepha Blazek). The 
interspace between the thoraces may, however, have simply been the addition 


of the first artist who portrayed the Maids (from imagination ?) ; then it may 
be surmised that they were ectopagous twins. 

" Pvgopagous twins are fetuses united together in the region of tlie nates 
and having each its own pelvis. In the recorded cases the union has 
been usually between the sacra and coccyges, and has been either osseous or 
(more rarely) ligamentous. Sometimes the point of junction was the middle 
line posteriorly, at other times it was rather a posterolateral union ; and it 
is probable that in the Biddenden Maids it was of the latter kind ; and it is 
likelv, from the proposal made to separate the sisters after the death of one, 
that it was lio-amentous in nature. 

"If it be granted that the Biddenden Maids were pygopagous twins, a 
study of the histories of other recorded cases of this monstrosity serves to 
demonstrate many common characters. Thus, of the 8 cases which Taruffi 
has collected, in 7 the twins were female ; and if to these we add the 
sisters Rosalie and Josepha Blazek and the Maids, we have 10 cases, of 
which 9 were girls. Again, several of the pygopagous twins, of whom 
there are scientific records, survived birth and lived for a number of years, 
and thus resembled the Biddenden terata. Helen and Judith, for instance, 
were twenty-three years old at death ; and the North Carolina twins, although 
born in 1851, are still alive. There is, therefore, nothing inherently improb- 
able in the statement that the Biddenden Maids lived for thirty-four years. 
With regard also to tlie truth of the record that the one Maid survived 
her sister for six hours, there is confirmatory evidence from scientifically 
observed instances, for Joly and Peyrat (Bull, de I'Acad. Med., iii., pp. 51 
and 383, 1874) state that in the case seen by them the one infant lived 
ten hours after the death of the other. It is impossible to make any 
statement with regard to the internal structure of the Maids or to the 
characters of their genital organs, for there is absolutely no information fortli- 
coming upon these points. It may simply be said, in conclusion, that the 
phenomenon of Biddenden is interesting not only on account of the curious 
bequest which arose out of it, but also because it was an instance of a very 
rare teratologic type, occurring at a very early period in our national 

Possil)ly the most famous example of twins of this type were Helen and 
Judith, the Hungarian sisters, born in 1701 at Szony, in Hungary. They 
were the objects of great curiosity, and were shown successively in Holland, 
Germany, Italy, France, England, and Poland. At the age of nine they 
were placed in a convent, where they died almost simultaneously in their 
twenty-second year. During their travels all over Europe they were exam- 
ined by many prominent physiologists, psychologists, and naturalists ; Pope 
and several minor poets have celebrated their existence in verse ; Buffon 
speaks of them in his "Natural History," and all the works on teratology for 
a century or more have mentioned them. A description of them can be best 



given bv a quaint translation by Fisher of the Latin lines composed by a 
Hungarian physician and inscribed on a bronze statuette of them :" — 

Two sisters wonderful to beliokl, who have thus grown as one, 

That naught their bodies can divide, no power beneath the sun. 

The town of Szoenii gave them birth, hard by far-fiimed Konioru, 

Which noble fort may all tlie arts of Turkish sultans scorn. 

Lueina, woman's gentle friend, did Helen first receive ; 

And Judith, when three hours had passed, her mother's womb did leave. 

One urine passage serves for both ; — one anus, so they tell ; 

The other parts their numbers keep, and serve their owners well. 

Their jiarents jwor did send them forth, the world to travel through. 

That this great wonder of the age should not be hid from view. 

The inner parts concealed do lie hid from our eyes, alas ! 

But all the body here you view erect in solid bi'ass. 

They were joined back to back in the lumbar region, and had all their 
parts separate except the anus between the right thigh of Helen and the 
left of Judith and a single vulva. Helen Mas the larger, better looking, 

the more active, and the more intelligent. 
Judith at the age of six became hemiplegic, 
and afterward was rather delicate and de- 
pressed. They menstruated at sixteen and 
continued with regularity, although one began 
before the other. They had a mutual affection, 
and did all in . their power to alleviate the 
circumstances of their sad position. Judith 
died of cerebral and pulmonary affections, and 
Helen, who previously enjoyed good health, 
soon after her sister's first indisposition sud- 
denly sank into a state of collapse, althougli 
preserving her mental faculties, and expired 
almost immediately after her sister. They had 
measles and small-pox simultaneously, but were 
affected in different degree l)v the maladies. 
The emotions, inclinations, and appetites were 
not simultaneous. Eccardus, in a very inter- 
esting paper, discusses the physical, moral, and religious questions in refer- 
ence to these wonderful sisters, such as the advisability ofi separation, the 
admissibility of matrimony, and, finally, whether on tlie last day they would 
rise as joined in life, or separated. 

There is an account'' of two united females, similar in conjunction to the 
"Hungarian sisters," who were born in Italy in 1700. They were killed at 
the age of four months by an attempt of a surgeon to separate them. 

-a 773, 1866. l* 105, v., 445. 

Fig. 40. — The Hungarian sisters. 



In 1856 there was reported to have been born in Texas, twins after the 
manner of Helen and Judith, united back to back, Avho lived and attained 
some age. They were said to have been of different natures and dispositions, 
and inclined to quarrel very often. 

Pancoast ^ gives an extensive report of Millie-Christine, who had been 
extensively exhibited in Europe and the United States. They were born of 
slave parents in Columbus County, N. C, July 11, 1851 ; the mother, who 
had borne 8 children before, wits a stout negress of thirty-two, with a large 
pelvis. The presentation was first by the stomach and afterward by the 
breech. These twins were united at the sacra by a cartilaginous or possil)ly 
osseous union. They were exhibited 
in Paris in 1873, and provoked as 
much discussion there as in the United 
States. Physically, ^Millie was the 
weaker, but had th(> stronger will and 
the dominating spirit. They menstru- 
ated regularly from the age of thir- 
teen. One from long habit yielded 
instinctively to the other's move- 
ments, thus preserving the necessary 
harmony. They ate sejiarately, had 
distinct thoughts, and carried on dis- 
tinct conversations at the same time. 
They experienced hunger and thirst 
generally simultaneously, and defe- 
cated and urinated nearly at the same 
times. One, in trancjuil sleep, would 
be wakened by a call of nature of the 
other. Common sensibility was ex- 
perienced near the location of union. 
They were intelligent and agreeable 
and of pleasant appearance, although 

slightly under size; they sang duets with })k'asant voices and accompanied 
themselves with a guitar ; they walked, ran, and danced with ap])arent ease 
and grace. Christine could bend over and lift Millie up by the bond of 

A recent example of the pygopagus type was Rosa- Josepha Blazek, '' 
born in Skerychov, in Bohemia, January 20, 1878. These twins had a broad 
bony union in the lower part of the lumbar region, the pelvis being obviously 
completely fused. They had a common urethral and anal aperture, l)ut a 
double vaginal orifice, with a very apparent septum. The sensation was dis- 
tinct in each, except where the pelves joined. They were exhibited in Paris 

a 631, 1871, i. b 778, xxii., 265. 

1-ig. 41. — Miliir-rliristiiiL- (^Paiiciiast ). 



in 1891, being then on an exhibition tour around the world. Rosa was the 
stronger, and when she walked or ran forward she drew her sister with her, 
who must naturally have reversed her steps. They had independent thoughts 
and separate minds ; one could sleep while the other was awake. ]\Iany of 
their appetites were different, one preferring beer, tlie other wine ; one relished 
salad, the other detested it, etc. Thirst and hunger were not simultaneous. 
Baudoin '■* describes their anatomic construction, their mode of life, and their 
mannerisms and tastes in a quite recent article. Fig. 42 is a reproduction 
of an early photograph of the twins, and Fig. 43 represents a recent photo- 
graph of these " Bohemian twins," as they are now called. 

FiR. 42. — Blazek sisters. 

The latest record we have of this type of monstrosity i? that given by 
Tynberg to the County Medical Society of Xew York, ]May 27, 1895. The 
mother was present with the remarkable twins in her arms, crying at the top 
of their voices. These two children w^ere born at midnight on April loth. 
Tynberg remarked that he believed them to be distinct and separate children, 
and not dependent on a common arterial system ; he also expressed his inten- 
tion of separating them, but did not believe the operation could be performed 
Avith safety before another year. Jacobi '' describes in full Tynberg's instance 
of pygopagus. He says the confinement was easy ; the head of one was born 
first, soon followed by the feet and the rest of the twins. The placenta was 

a 728, July 8, 1891. b 165, Oct., 1895. 



single and the cord consisted of two branches. The twins were nnited 
below the third sacral vertebrae in such a manner that they could lie along- 
side of each other. They were females, and had two vaginae, two urethrae, 
four labia minora, and two labia majora, one anus, but a double rectum 
divided by a septum. They micturated independently but defecated simul- 
taneously. They virtually lived separate lives, as one might be asleep while 
the other cried, etc. 

Class Y. — While instances of ischiopagi are quite numerous, few have 
attained any age, and, necessarily, little notoriety. Pare-'' speaks of twins 


1 iy. 4.;. lluhviai.iii twins. 

united at the pelves, who were born in Paris July 20, 1570. They were 
baptized, and named Louis and Louise. Their parents were well known 
in the rue des Gravelliers. According to Batcman,'-" and also RueflF, in the 
year 1552 there were born, not far from Oxford, female twins, who, from the 
description given, were doubtless of the ischiopagus type. They seldom 
wept, and one was of a cheerful disposition, while the other was heavy and 
drowsy, sleeping continually. They only lived a short time, one expiring a 
day before the other. Licetus ^^''' speaks of ]\Irs. John Waterman, a resident 
of Fishertown, near Salisbury, England, who gave birth to a double female 
monster on October 26, 1664, which evidently from the description was 

a 618, 1010. 



joined by the ischii. It did not nurse, but took food by both the mouths ; 
all its actions were done in concert ; it was possessed of one set of genito- 
urinary organs ; it only lived a short while. Many people in the region 
flocked to see the wonderful child, whom Licetus called " Monstrum Angli- 
cum." It is said that at the same accouchement the birth of this monster 
was followed by the birth of a well-formed female child, who survived. 
GeoflProy-Saint-Hilaire (juotes n description of twins who were born in Franco 
on October 7, ISoS, symmetrically formed and united at their ischii. ()ne 
was christened Marie-Louise, and the other Hortense-Honorine. Their 
avaricious parents took the children to Paris for exhibition, the exposures 
of which soon sacrificed their lives. In the year 1841 there was born in 
the island of Ceylon, of native parents, a monstrous child that was soon 

Fig-. 44.— Tynberg's case. 

brought to Columbo, where it lived only two months.^ It had two heads 
and seemed to have duplication in all its parts except the anus and male 
generative organs. JMontgomery '' speaks of a double child born in County 
Roscommon, Ireland, on the 24th of July, 1827. It had two heads, two 
chests with arms complete, two abdominal and pelvic cavities united end to 
end, and four legs, placed two on either side. It had only one anus, which 
was situated between the thighs. One of the twins was djark haired and 
was baptized Mary, while the other was a blonde and was named Catherine. 
These twins felt and acted independently of each other ; they each in succes- 
sion sucked from the breast or took milk from the spoon, and used their 
limbs vigorously. One vomited without affecting the other, but the feces 
were discharged through a common opening. 

a 318, vol. Ixi., 58. b 313^ vol. xv. 



Goodell -'' speaks of Minna and Minnie Finley, who were born in Ohio 
and examined by liim. Thev were i'used tugetiier in a common longitudinal 
axis, having one pelvis, two heads, four legs, and four arms. One was weak 
and puny and the other robust and active ; it is probable that they had but 
one rectum and one bladder. Goodell accompanies his description by the 
mention of several analogous cases. Ellis '^ speaks of female twins, born in 
Millville, Tenn., and exhibited in Xew York in ISGS, wlio were joined at 
the pelves in a longitudinal axis. Between the limbs on either side were to 
be seen well-developed female genitals, and the sisters had been known to 
urinate from both sides, beginning and ending at the same time. 

Huif <= details a description of the *'Jones twins," born on June 24, 1889, 
in Tipton County, Indiana, whose spinal columns were in apposition at the 
lower end. The labor, of less than two hours' duration, was completed 

Fig. 45.— The Jones twins. 

before the arrival of the physician. Lying on their mother's back, they could 
both nurse at the same time. Both sets of genitals and ani were on the 
same side of the line of union, but occupied normal positions with reference 
to the legs on either side. Their weight at birth was 12 pounds and tlieir 
length 22 inches. Their mother was a medium-sized l)runette of Id, and had 
one previous child then living at the age of two ; their father was a finely 
formed man 5 feet 10 inches in height. The twins differed in complexion 
and color of the eyes and hair. They were publicly exhibited for some time, 
and died February 19 and 20, 1891, at St. John's Hotel, Buffalo, N. Y. 
Figure 45 shows their appearance several months after Ijirth. 

Class YI. — In our sixth class, the first record we have is from the Com- 
mentaries of Sigbert, which contains a description of a monstrosity born in the 
reign of the Emperor Theodosins, who had two heads, two chests with four 

a 547, 1870. b 218, 1871, 218 et seq. c 125, vol. xxii., 923. 


arms attaclied, but a single lower extremity. The emotions, affections, and 
appetites were different. One head might be crying while the other laughed, 
or one feeding while the other was sleeping. At times they quarreled and 
occasionally came to blows. This monster is said to have lived two years, 
one part dying four days before the other, which evinced symptoms of decay 
like its inseparable neighbor. 

Roger of Wendover*'^^ says that in I^esser Brittany and Xormandv, in 
1062, there was seen a female monster, consisting of two women joined about 
the umbilicus and fused into a single lower extremity. They took their 
food by two mouths but expelled it at a single orifice. At one time, one of 
the women laughed, feasted, and talked, while the other Mcpt, fasted, and kept 
a religious silence. The account relates how one of them died, and the survi- 
vor bore her dead sister al)0ut for three years before she was overcome by the 
oppression and stench of the cadaver. Batemen ^^^ describes the birth of a boy 
in 1529, who had two heads, four ears, four arms, but only two tliiglis and two 
legs. Buchanan^ speaks at length of the famous ''Scottish Brothers,'* 
who were the cynosure of the eyes of the Court of James III, of Scotland. 
This monster consisted of two men, ordinary in appearance in the superior 
extremities, whose trunks fused into a sinole lower extremity. The Kinsr 
took diligent care of their education, and they became proficient in music, 
languages,' and other court accomplishments. Between them they would 
carry on animated conversations, sometimes merging into curious debates, 
fbllovved by blows. Above the point of union they had no synchronous sen- 
sations, while below, sensation was common to both. This monster lived 
twenty-eight years, surviving the royal patron, who died June, 1488. One 
of the brothers died some days before the other, and the survivor, after 
carrying about his dead brother, succumbed to '' infection from putrescence." 
There was reported to have been born'^^ in Switzerland a double-headed 
male monster, who in 1538, at the age of thirty, was possessed of a beard on 
each face, the two bodies fused at the umbilicus into a single lower extremity. 
These two twins resembled one another in contour and countenance. They 
Avere so joined that at rest they looked upon one another. They had a 
single wife, with whom they w^ere said to have lived in harmony. In the 
Gentleman's Magazine about one hundred and fifty years since there was 
given the portrait and description of a double woman, who was exhibited all 
over the large cities of Europe. Little can be ascertained anatomically of her 
construction, with the exception that it was stated that she had two heads, 
two necks, four arms, two legs, one pelvis, and one set of pelvic organs. 

The most celebrated monster of this type was Ritta-Christina (Figs. 46 

and 47), who Avas born in Sassari, in Sardinia, March 23, 1829. These twins 

were the result of the ninth confinement of their mother, a woman of thirty-two. 

Their superior extremities were double, but they joined in a connnon trunk 

aRerum Scoticarum Historia, Aberdeen, 1762, L. xiii. 



nt a point a little below the mammse. Below this point they had a common 
trunk and single lower extremities. The right one, christened Ritta, was 
feeble and of a sad and melancholy countenance ; the left, Christina, was 
vigorous and of a gay and happy aspect. They suckled at different times, 
and sensations in the uj)per extremities were distinct. Tiiey expelled urine 
and feces simultaneously, and had the indications in common. Their parents, 
who were very poor, brought them to Paris for the purpose of public exhibi- 
tion, which at first was accomplished clandestinely, but finally interdicted by 
the public authorities, who feared that it would open a door for psychologic 
discussion and speculation. This failure of the parents to secure ])ublic 
patronage increased their poverty and hastened the death of the children by 
unavoidal)le exposure in a cold room. The nervous system of the twins had 
little in common except in the line of union, the anus, and the sexual organs, 

Fig. 46. — Skeleton of Ritta-Christina. 

Fig. 47. — Ritta-Chri.stina. 

and Christina was in good health all through Ritta's sickness ; when Ritta 
died, her sister, who was suckling at the mother's breast, suddenly relaxed 
hold and expired with a sigh. At the postmortem, which was secured 
with some difficulty on account of the authorities ordering the bodies to be 
burned, the pericardium was found single, covering both hearts. Tlie diges- 
tive organs were double and separate as far as the lower third of the ilium, 
and the cecum was on the left side and single, in common with the lower 
bowel. The livers were fused and the uterus was double. The vertebral 
columns, which were entirely separate above, were joined below by a rudi- 
mentary OS innominatum. There was a junction between the manubrium of 
each. Sir Astley Cooper saw a monster in Paris in 1792 which, by his 
description, must have been very similar to Ritta-Christina. 



The Tocci brothers were born in 1877 in the province of Turin, Italy, 
They each liad a Mell-lornied head, perfect arms, and a perfect thorax to the 
sixth rib ; they had a common abdomen, a single anus, two legs, two sacra, two 
vertebral columns, one penis, but three buttocks, the central one containing a 
rudimentary anus. The right l)oy was christened Giovanni-Batista, and the 

left Giacomo. Each individual 
had power over the corresponding 
leg on his side, but not over the 
other one. Walking was there- 
fore imj)ossible. All their sensa- 
tions and emotions were distinctly 
individual and independent. At the 
time of the report, in 1882, they 
w^ere in good health and showed 
every indication of attaining adult 
age. Figure 48 represents these 
twins as they w^ere exhibited sev- 
eral years ago in Germany. 

McCallum'* saw two female 
children in Montreal in 1878 
named Marie - Rosa Drouin. 
Thev formed a riuht anole with 
their single trunk, which com- 
menced at the lower part of the 
thorax of each. They had a single 
genital fissure and the external 
organs of generation of a female. 
A little over three inches from the 
anus was a rudimentary limb with 
a movable articulation ; it meas- 
ured five inches in length and 
tajx'red to a fine point, being fur- 
nished with a distinct nail, and it 
contracted strongly to irritation. 
Marie, the left child, was of fair 
complexion and more strongly 
developed than Rosa. The sen- 
sations of hunger and thirst were not experienced at the same time, and one 
might be asleep while the other was crying. The pulsations and the respira- 
tory movements were not synchronous. They were the products of the 
second gestation of a mother aged twenty-six, whose abdomen was of such 
preternatural size during pregnancy that she was ashamed to appear in public, 

a 778, vol. XX., 120. 

Fig. 48. — The Tocci hrotliers. 


The order of birth was as follows : one head and body, the lower extremity, 
and the second body and head. 

Class VII. — There are many instances of bicephalic monsters on 
record. Pare ^ mentions and gives an illustration of a female apparently sin- 
gle in conformation, with the exception of having two heads and two necks. 
The Ephemerides, Haller, Schenck, and Archenholz cite examples, and there is 
an old account '^ of a double-headed child, each of whose heads were baptized, 
one called Martha and the other Mary. One was of a gay and the other a 
sad visage, and both heads received nourishment ; they only lived a couple 
of days. There is another similar record of a Milanese girl who had two 
heads, but was in all other respects single, with the exception that after death 
she was found to have had two stomachs. Besse mentions a Bavarian woman 
of twenty-six with two heads, one of which was comely and the other extremely 
ugly; Batemen^-'^ quotes what is apparently the same case — a woman in 
Bavaria in 1541 with two heads, one of which was deformed, who begged 
from door to door, and who by reason of the influence of pregnant women 
was given her expenses to leave the country. 

A more common occurrence of this type is that in Avhich there is fusion of 
the two heads. Moreau ^ speaks of a monster in Spain which was shown from 
town to town. Its heads were fused ; it had two mouths and two noses ; in eacli 
face an eve well conformed and placed above the nose ; there was a third, eye 
in the middle of the forehead common to both heads ; the third eye was of 
primitive development and had two pupils. Each face was well formed and 
had its own chin. Buffon mentions a cat, the exact analogue of Moreau's 
case. Sutton'^ speaks of a ])hotograph sent to Sir James Paget in 1856 by 
AVilliam Budd of Bristol. This portrays a living child with a supernumerary 
head, which had mouth, nose, eyes, and a brain of its own (Fig. .49). The 
evelids were abortive, and as there was no orbital cavity the eyes stood out 
in the form of naked globes on the forehead. When born, the corneas of 
both heads were transparent, but then became opaque from exposure. The 
brain of the supernumerary head was quite visible from without, and was 
covered by a meml)rane beginning to slough. On the right side of the head 
was a rudimentary external ear. The nurse said that when the cliild sucked 
some milk regurgitated through the supernumerary mouth. The great phy- 
siologic interest in this case lies in the fact that every movement and every 
act of the natural face was simultaneously repeated by the supernumerary 
face in a perfectly consensual manner, /. e., when the natural mouth sucked, 
the second mouth sucked ; when the natural ftice cried, yawned, or sneezed, 
the second fice did likewise ; and the eyes of the two heads moved in unison. 
The fate of the child is not known. 

Home "^ speaks of a child born in Bengal with a most peculiar fusion of 

.a 618, 1006. b 469, 1665. c Quoted, 302, xxxiv., 171. 

d275, 1895, 133. ^ 629, 1791, 299. 



the head. The ordinary liead was nearly perfect and of usual volume, but 
fused Avitli its vertex and reversed was a supernunierarv head (Fig. oO). 
Each head had its own separate vessels and Ijrain, and each an individual 
sensibility, but if one had milk first the other had an abundance of saliva in 
its mouth. It narroAvly escaped being burned to death at birth, as the mid- 
wife, greatly frightened by the monstrous appearance, threw it into the fire 
to destroy it, from whence it was rescued, although badly burned, the vicious 
conformation of the accessory head being possibly due to the accident. At 
the age of four it was bitten by a venomous serpent and, as a result, died. 
Its skull is in the possession of the Royal College of Surgeons in London. 

Fig. 49. — Infant with a supernumerary head 
(after Sutton). 

Fig. 50. — Two-headed bor (Home's case). 

The following well-known story of Edward Mordake, though taken from 
lay sources, is of sufficient notoriety and interest to be mentioned here : — 

" One of the weirdest as well as most melancholy stories of human de- 
formity is that of Edward Mordake, said to have been heir to one of the 
noblest peerages in England. He never claimed the title, however, and com- 
mitted suicide in his twenty-third year. He lived in complete seclusion, 
refusing the visits even of the members of his own family. He was a young 
man of fine attainments, a profound scholar, and a musician of rare ability. 
His figure was remarkable for its grace, and his face — that is to say, his 
natural face — was that of an Antinous. But upon the back of his head was 
another face, that of a beautiful girl, ' lovely as a dream, hideous as a devil.' 
The female face was a mere mask, 'occupying only a small portion of 
the posterior part of the skull, yet exhibiting every sign of intelligence, of a 


malignant sort, however.' It woiikl be seen to smile and sneer while Mor- 
dake was weeping. The eyes would follow the movements of the spectator, 
and the lips would ' gibber without ceasing.' Xo voice was audible, but 
Mordake avers that he was kept from his rest at night l)v the hateful whis- 
pers of his ' devil twin,' as he called it, ' which never sleeps, but talks to 
me forever of such things as they only speak of in hell. Xo imagination 
can conceive the dreadful temptations it sets before me. For some 
unforgiven wickedness of my forefathers I am knit to this fiend — for a 
fiend it surely is. I beg and beseech you to crush it out of human 
semblance, even if I die for it.' Such were the words of the hapless 
Mordake to Manvers and Treadwell, his physicians. In spite of careful 
watching he managed to procure poison, whereof he died, leaving a letter 
requesting that the ' demon face ' might be destroyed before his burial, ' lest 
it continues its dreadful Avhisperings in my grave.' At his own request he 
was interred in a waste place, without stone or legend to mark his grave." 

A most curious case was that of a Fellah woman-* who was delivered at 
Alexandria of a bicephalic monster of apparently eight months' pregnancy. 
This creature, which was born dead, had one head white and the other black, 
the change of color commencing at the neck of the black head. The bizarre 
head was of negro conformation and fully developed, and the colored skin 
was found to be due to the existence of pigment similar to that found in the 
black race. The husband of the woman had a light brown skin, like an 
ordinary Fellah man, and it was ascertained that there were some negro 
laborers in port during the woman's pregnancy ; but no definite information 
as to her relations with them could l)e established, and whether this was a 
case of maternal impression or superfetation can only be a matter of conjecture. 

Fantastic monsters, such as acephalon, paracephalon, cyclops, pseuden- 
cephalon, and the janiceps (Fig. 51), prosopthoracopagus (Fig. 52), dispro- 
sopus (Fig. 53), etc., although full of interest, will not be discussed here, as 
none are ever viable for any length of time, and the declared intention of 
this chapter is to include only those beings who have lived. 

Class YIII. — The next class includes the parasitic terata, monsters 
that consist of one perfect body, complete in every respect, but from the 
neighborhood of whose uml)ilicus depends some important portion of a second 
body. Pare, Benivenius, and Columbus describe adults with acephalous 
monsters attached to them. Schenek mentions 1.3 cases, 3 of which were 
observed by him. Aldrovandtis'^'' shows 3 illustrations under the name 
of " monstrum bicorpum monocephalon." Buxtorf^ speaks of a case in 
which the nates and lower extremities of one body proceeded out of the 
abdomen of the other, which was otherwise perfect. Reichel and Ander- 
son ^ mention a living parasitic monster, the inferior trunk of one body pro- 
ceeding from the pectoral region of the other. 

a 789, Aug. 5, 1848. b 107, vol. vii., u. xii., 101. "^ 629, vol. Ixxix. 



Pare** says that there was a man in Paris in 1530, quite forty years of 
age, wlio carried about a ])arasite without a head, whicli hung pendant from 
his belly. This individual was exhibited and drew great crowds. Pare 

Fig. 51.— Janiceps. 

Fig. 52. — Prosopthoracopagus- 

Fig. 53. — Disprosopus. 

appends an illustration, which is, perhaps, one of the most familiar in all tera- 
tology. He also '^ gives a portrait (Fig. 54) of a man who had a parasitic head 

Fig. .54. — Parasitic monster (after Par^). 

Fig. 55. — Tiioracopagus. Lazarus-Joanne.s Baptista 

proceeding from his epigastrium, and who was born in Germany the same 

year that peace was made with the Swiss by King Francis. This creature lived 

a 618, 1007. b618, 1012. 


to manhood and both heads were utilized in alimentation. Bartholinus ^ details 
a history of an individual named Lazarus- Joannes Baptista Colloredo (Fig. 
55), born in Genoa in 1617, who exhibited himselt all over Europe. From 
his epigastrium hung an imperfectly developed twin that had one thigh, hands, 
body, arms, and a well-formed head covered with hair, which in the normal 
position hung lowest. There were signs of independent existence in the 
parasite, movements of respiration, etc., but its eyes were closed, and, although 
saliva constantly dribbled from its open mouth, nothing was ever ingested. 
The genitals were imperfect and the arms ended in badly formed hands. 
Bartholinus examined this monster at twenty-two, and has given the best 
report, although while in Scotland in 1642 he was again examined, and ac- 
credited with being married and the father of several children who were fully 
and admirably developed. Moreau quotes a case of an infant similar in con- 
formation to the foregoing monster, who was born in Switzerland in 1764, and 
whose supernumerary parts were amputated by means of a ligature. Winslow 
reported before the Academic Royale des Sciences the history of a girl of 
twelve who died at the Hotel-Dieu in 1733. She was of ordinary height 
and of fair conformation, with the exception that hanging from the left 
flank was the inferior half of another girl of diminutive proportions. The 
supernumerary Ijody was immovable, and hung so heavily that it was said 
to be supported by the hands or by a sling. Urine and feces were evacu- 
ated at intervals from the parasite, and received into a diaper constantly 
worn for this jjurpose. Sensibility in the two was common, an impres- 
sion applied to the parasite being felt by the girl. A\'inslow gives an inter- 
esting report of the dissection of this monster, and mentions that he had 
seen an Italian child of eight who had a small head proceeding from under 
the cartilage of the third left rib. Sensibility was conmion, pinching the ear 
of the parasitic head causing the child with the perfect head to cry. Each 
of the two heads received baptism, one being named John and the other 
Matthew. A curious question arose in the instance of the girl, as to whether 
the extreme unction should be administered to the acephalous fetus as well 
as to the child. 

In 1742, during the Ambassadorship of the Marquis de I'Hopital at 
Naples, he saw in that city an aged man, well conformed, with the exception 
that, like the little girl of Winslow, he had the inferior extremities of a male 
child growing from his epigastric region. Haller and ^Meckel have also 
observed cases like this. Bordat descril)ed before the Royal Institute of 
France, August, 1826, a Chinaman, twenty-one years of age, who had an 
acephalous fetus attached to the surface of his breast (possibly " A-ke"). 

Dickinson ** describes a wonderful child Ave years old, who, by an extra- 
ordinary freak of nature, was an amalgamation of two children. From the 
body of an otherwise perfectly formed child was a supernumerary head pro- 

a 190, hist. Iviii. ^ 703, 1880. 



truding from a broad l)a<e attached to the lower hinil)ar and sacral region^ 
This cephalic mass was covered with hair about four or live inches long, and 
showed tlie rudiments of an eye, nose, mouth, and cliin. This child was on 
exhibition when Dickinson saw it, Montare and Reyes were commissioned 
by the Academy of Medicine of Havana to examine and report on a mon- 
strous girl of seven months, living in Cuba. The girl was healthy and well 
developed, and from the middle line of her body between the xiphoid carti- 
lage and the umbilicus, attaclicd l>y a soft pedicle, was an accessory individual, 
irregular, of ovoid shajie, the smaller end, representing the head, being upward. 
The parasite measured a little over 1 foot in length, 9 inches about the head, 
and 7| inches around the neck. The cranial bones were distinctly felt, and 
the top of the head was covered by a circlet of hair. There were two rudi- 
mentary eyebrows ; the left eye was represented by a minute perforation 
encircled with hair ; the right eye w^as traced by one 
end of a nuicous groove Avhicli ran down to another 
transverse groove representing the mouth ; the right 
third of this latter groove showed a primitive tongue 
and a triangular tooth, which appeared at the fifth 
month. There was a soft, imperforate nose, and the 
elements of the vertebral column could be distinguished 
beneath the skin ; there were no legs ; apparently no 
vascular sounds ; there w^as separate sensation, as the 
parasite could be pinched without attracting the per- 
fect infiint's notice. The mouth of the parasite con- 
stantly dribbled saliva, but showed no indication of 
receiving aliment.^ 

Louise L., known as "La dame a quatre 
jambes," was born in 1869, and had attached to her 
Fig. 56.— Louise L. pclvis auothcr rudimentary pelvis and two atrophied 

legs of a parasite, w'eighing 8 kilos. The attachment 
was effected by means of a pedicle 33 cm. in diameter, having a bony basis, 
and being fixed Avithout a joint. The attachment almost obliterated the 
vulva and the perineum was displaced far Ijackward. At the insertion of 
the parasite were two rudimentary mammje, one larger than the other (Fig. 
56). Xo genitalia were seen on the jiarasite and it exhibited no active move- 
ments, the joints of both limbs being ankylosed. The woman could localize 
sensations in the parasite except those of the feet. She had been married 
five years, and bore, in the space of three years, two well-formed daughters. 
Quite recently there was exhibited in the museums of the United States 
an individual liearing tlie name " Laloo," who was born in Oudh, India, and 
was the second of four children. At the time of examination he was about 
nineteen years of age. The upper portion of a parasite was firmly attached 

a 224, 1886, i., 81. 



to the lower right side of the sternum of the individual by a bony pedicle, and 
lower by a fleshy pedicle, and apparently contained intestines. The anus of 
the parasite was imperforate ; a well-developed penis was found, but no testi- 
cles ; there was a luxuriant growth of hair on the pubes. The penis of the 
parasite was said to show signs of erection at times, and urine passed through 
it without the knowledge of the boy. Perspiration and elevation of tem- 
perature seemed to occur simultaneously in both. To pander to the morbid 
curiosity of the curious, the " Dime Mu- 
seum " managers at one time shrewdly 
clothed the parasite in female attire, 
calling the two brother and sister ; but 
there is no doubt that all the traces of 
sex were of the male type. An anal- 
ogous case was that of '^ A-Ke," a 
Chinaman, who was exhibited in London 
early in the century, and of whom and 
his parasite anatomic models are seen 
in our museums. Figure 58 repre- 
sents an epignathus, a ])eculiar type of 
parasitic monster, in which the parasite 
is united to the inferior maxillary bone 
of the autosite. 

Class IX. — Of " Lusus natune" 
none is more curious than tliat of dup- 
lication of the lower extremities. 
Pare" says that on January 9, 1021), 
there was living in Germany a male 
infant having four legs and four arms. 
In Paris, at the Academic des Sciences, 
on September 6, 1830, there was pre- 
sented by Madame Hen, a midwife, ti 
living male child with four legs, tiio 
anus being nearly below the middle of 
the third buttock ; and the scrotum 
between the two left thighs, the testicles 
not yet descended. There was a well- 
formed and single pelvis, and the supernumerary legs were immovable. 
Aldrovandus mentions several similar instances, and gives the figure of one 
born in Rome ; he also describes several quadruped birds. Bardsley ^ speaks 
of a male child with one head, four arms, four legs, and double generative 
organs. He gives a portrait of the child when it was a little over a year old. 
Heschl published in Vienna in 1878 a description of a girl of seventeen, 

a 618, 1012. b781, 1838, vol. vi. 


Fig. 57. — Laloo. 



who Instead of having a (hiplication of the superior body, as in "Millie- 
Christine, the two-headed nightingale," had double parts below the second 
lumbar vertebra. Her head and upper body resembled a coniel}', delicate 
girl of twelve. 

AVells ^ describes Mrs. B., aged twenty, still alive and healthy (Fig. 59). 
The duplication in this case begins just above the waist, the spinal column 
dividing at the third lumbar vertebra, below this point everything being 
double. Micturition and defecation occur at diiferent times, but menstrua- 
tion occurs simultaneously. She was married at nineteen, and became preg- 
nant a year later on the left side, but abortion Avas induced at the fourth 
month on account of persistent nausea and the expectation of impossible 
delivery. AVhaley,^ in speaking of this case, said ]Mrs. B. utilized her out- 
side legs for walking ; he also remarks that when he informed her that she 
was pregnant on the left side she replied, " I think you are mistaken ; if it 

had been on my right side I AAOuld come 
nearer believing it ;" — and after further 
questioning he found, from the patient's 
observation, that her right genitals were 
almost invariably used for coitus. 

Bechlinger of Para, Brazil,*^ describes 
a woman of tAventy-five, a native of 
Martinique, whose father was French 
and mother a quadroon, who had a 
modified duplication of the lower body. 
There was a third leg attaclied to a con- 
tinuation of tlie processus coccygeus of 
the sacrum, and in addition to well- 
developed mamnife regularly situated, 
there were two rudimentary ones close to- 
gether above the pubes. There were two vaginae and two well-developed 
vulvie, both having equally developed sensations. The sexual appetite was 
markedly developed, and coitus was practised in both vaginae. A somewhat 
similar case, possibly the same, is that of Blanche Dumas, born in 1860. 
She had a very broad pelvis, two imperfectly developed legs, and a super- 
numerary limb attached to the symphysis, without a joint, but with slight 
passive movement. There was a duplication of bowel, bladder, and genitalia. 
At the junction of the rudimentary limb with the body, in front, were two 
rudimentary mammary glands, each containing a nipple (Fig. 60). 

Other instances of supernumerary limbs will be found in Chapter VI. 
Class X. — The instances of diphallic terata, l\v their intense interest 
to the natural bent of the curious mind, have always elicited much discus- 
sion. To many of these cases have been attributed exaggerated function, 
a 125, 1888, 1266. ^ 224, 1889, i., 96. ^^ Annals of Gynecology, 1888. 

Fig. 58. — Epignathus. 



Fig. 59.— Dipygus (Wells). 

notwithstanding the fact that modern observation ahiiost invariably shows 
that the virile power diminishes in exact proportion to the extent of duplica- 
tion. Taylor '"' quotes a description of a monster, exhil)ited in London, Avitli 
two distinct penises,'but with only 
one distinct testicle on either side. 
He could exercise the function of 
either organ. 

Schenck, Schurig, Bartholinus, 
Loder, and Ollsner report instances 
of diphallic terata ; the latter case ^ 
was in a soldier of Charles VI., 
twenty-two years old, who applied 
to the surgeon for a bubonic affec- 
tion, and who declared that he 
passed urine from the orifice of 
the left glans and also said that he 
was incapable of true coitus. Val- 
entini mentions an instance in a 
boy of four, in which the two 
penises were superimposed. Buc- 
chettoni^ speaks of a man with 
two penises placed side by side. There was an anonymous case described <* 
of a man of ninety-three with a penis which was for more than half its length 

divided into two distinct members, 
the right being somewhat larger 
than the left. From the middle 
of the penis up to the symphysis 
only the lower wall of the urethra 
was split. Jenisch^^ describes a 
di}>liallic infant, the offspring of a 
woman of twenty-five who had 
been married five years. Her first 
child was a well-formed female, and 
the second, the infant in question, 
cried much during the night, and 
several times vomited dark-green 
matter. In lieu of one penis there 
were two, situated near each other, 
the riffht one of natural size and the 
left larger, but not furnished with a prepuce. Each penis had its own 
urethra, from which dribbled urine and some meconium. There was a 

a Medicorum Siles. Satyrse. Lipsise, 1736. ^ Auatomia, etc., p. 120, GEnipoiite, 1740. 

c 559, 1808, Baud ii., 335. d Med. Corresp.-Blatt des wurtterab. arztl. Ver., Stuttg., 1837. 

Fig. 60.— Blanche Dumas. 



Fig. CA. — Double penis (Jenisch's case). 

duplication of each scrotum, l)ut only one testicle in each, and several 
other minor malformations (Fig. (il). 

Gore, reported bv Velpeau,-'' has seen an infant of eight and one-half 

months with two penises and 
three lower extremities. The 
penises were 4 cm. apart and 
the scrotum divided, containing 
one testicle in each side. Each 
jienis was provided with a ure- 
thra, urine being discharged 
from both simultaneously. In 
a similar case, spoken of by 
Geotfr( >y-Saint-Hilaire, the two 
organs were also separate, but 
urine and semen escaped some- 
times from one, sometimes from 

The most celebrated of all 
the diphallic terata was Jean 
Baptista dos Santos, mIio when but six months old Avas spoken of by 
Actoii. His i'ather and mother Avere healthy and had two well-formed 
children. He was easily 
born after' an uneventful 
pregnancy. He Avas good- 
looking, well proportion- 
ed, and had tAVO distinct 
penises, each as large as 
that of a child of six 
months. Urination pro- 
ceeded simultaneously 
from both penises ; he had 
also two scrotums. Behind 
and between the legs there 
Avas another limb, or rather 
tAVO, united throughout 
their length. It Avas con- 
nected to the pubis by a 
short stem J inch long 
and as large as the little 
finger, consisting of separ- 
ate bones and cartilages. There Avas a patella in the supernumerary limb 
on the anal aspect, and a joint freely movable. This compound limb had no 

a 283, 1844. 

Fig. 62.— Jean Baptista dos Santos. 


power of motion, but was endowed with sensibility. A journal in London," 
after quoting Acton's description, said that the child had been exhibited 
in Paris, and that th$ surgeons advised operation. Fisher,*^ to whom we 
are indebted for an exhaustive work in Teratology, received a report from 
Havana in July, 1865, which detailed a description of Santos at twenty- 
two years of age, and said that he was possessed of extraordinary animal 
passion, the sight of a female alone being sufficient to excite him. He was 
said to use both penises, after finishing with one continuing with the other ; 
but this account of him does not agree with later descriptions, in which no 
excessive sexual ability had been noticed. Hart ° describes the adult Santos 
in full, and accompanies his article with an illustration. At this time he 
was said to have developed double genitals, and ])ossibly a double bladder 
communicating by an imperfect septum. At adulthood the anus was three 
inches anterior to the os coccygeus. In the sitting or lying posture the 
supernumerary limb rested on the front of the inner surface of the lower third 
of his left thigh. He Avas in the habit of wearing this limb in a sling, or 
bound firmly to the right tliigh, to prevent its unseemly dangling when erect. 
The perineum proper was absent, the entire space between the anus and the 
posterior edge of the scrotum being occupied by the pedicle. Santos' mental 
and physical functions were developed above normal, and he impressed 
everybody with his accomplishments. Geoffroy-Saint-Hilaire records an in- 
stance in which the conformation was similar to that of Santos. There was 
a third lower extremity consisting of two limbs fused into one with a single 
foot containing ten distinct digits. He calls the case one of arrested twin 

Van Buren and Keyes '^ describe a case in a man of forty-two, of good, 
healthy appearance. The two distinct penises of normal size were appa- 
rently well formed and were placed side by side, each attached at its root to 
the symphysis. Their covering of skin was common as far as the base of the 
glans ; at this point they seemed distinct and j>erfect, l)ut the meatus of the 
left was imperforate. The right meatus was normal, and through it most of 
the urine passed, though some always dribbled through an opening in the 
perineum at a point where the root of the scrotum should have been. On 
lifting the double-barreled penis this opening could be seen and was of suffi- 
cient size to admit the finger. On the right side of the aperture was an 
elongated and rounded prominence similar in outline to a labium majus. 
This ])rominence contained a testicle normal in shape and sensibility, but 
slightly undersized, and surrounded, as was evident from its mobility, by a 
tunica vaginalis. The left testicle lay on the tendon of the adductor longus 
in the left groin ; it was not fully developed, but the patient had sexual de- 
sires, erections, and emissions. Both penises became erect simultaneously, 

a 549, April, 1847, 322. b 773, I866. <= 47G, 1866, i., 71. 

d " Surgical Diseases of the Genito-Urinary Organs," New York, 1874. 


the right more vigorously. The left leg was shorter than the right and con- 
genitally smaller ; the mammae were of normal dimensions. 

Sangalli ^ speaks of a man of thirty-five who had a supernumerary penis, 
furnished with a prepuce and capable of erection. At the apex of the 
glans opened a canal about 12 cm. long, through which escaped monthly a 
serous fluid. Smith'' mentions a man who had two penises and two bladders, 
on one of which lithotomy was performed. According to Ballantyne, Taruffi, 
the scholarly observer of terata, mentions a child of forty-two months and 
height of 80 cm. who had two penises, each furnished with a urethra and well- 
formed scrotal sacs which were inserted in a fold of the groin. There were 
two testicles felt in the right scrotum and one in the left. Fecal evacuations 
escaped through two anal orifices. There is also another case mentioned 
similar to the foregoing in a man of forty ; but here there was an osseous 
projection in the middle line behind the bladder. This patient said that 
erection was simultaneous in both penises, and that he had not married 
because of his chagrin over his deformity. Cole ^ speaks of a child with two 
well-developed male organs, one to the left and the other to the right of the 
median line, and about ^ or J inch apart at ))irth. The urethra bifurcated 
in the perineal region and sent a branch to each penis, and urine passed from 
each meatus. The scrotum was divided into three compartments by two 
raphes, and' each compartment contained a testicle. The anus at Wrth was 
imperforate, but the child was successfully operated on, and at its sixtieth day 
weighed 17 pounds. 

Lange'* says that an infant was brought to Karg for relief of anal 
atresia when fourteen days old. It was found to possess duplicate penises, 
which communicated each to its distinct half of the bladder as defined by a 
median fold. The scrotum was divided into three portions by two raphes, and 
each lateral compartment contained a fully formed testicle. This child died 
because of its anal malformation, M'hich we notice is a frequent associate of 
malformations or duplicity of the penis. There is an example in an infant 
described ® in which there were two penises, each about I inch long, and a 
divided scrotal sac 2| inches long. Englisch^ speaks of a German of forty 
who possessed a double penis of the bifid type. 

Ballantyne and his associates define diphallic terata as individuals pro- 
vided with two more or less well-formed and more or less separate penises, who 
may show also other malformations of the adjoining parts and organs (e. g., 
septate l>ladder), but who are not possessed of more than twa lower limbs. 
This definition excludes, therefore, the cases in which in addition to a double 
penis there is a supernumerary lower extremity — such a case, for example, 
as that of Jean Baptista dos Santos, so frequently described by teratologists. 
It also excludes the more evident double terata, and, of course, the cases of 

a " Lascienza a e la prat. dell. anat. patoloo;." .Pavia, 1875, i.. 117. b 775, 1878. 91. 
c 579, 1894, 159. ^ 720, 1895, 215. e 759^ April, 1895. f Quoted 759, Oct., 1895. 


duplication of the female genital organs (double clitoris, vulva, vagina, and 
uterus). Although Schurig, Meckel, Himly, Taruffi, and others give bib- 
liographic lists of diphallic terata, even in them erroneous references are 
common, and there is evidence to show that many cases have been duplicated 
under different names. Ballantyne and Skirving ^ have consulted all the 
older original references available and eliminated duplications of reports, 
and, adhering to their original definition, have collected and described indi- 
vidually 20 cases ; they offer the following conclusions : — 

1. Diphallus, or duplication of the penis in an otherwise apparently single 
individual, is a very rare anomaly, records of only 20 cases having been 
found in a fairly exhaustive search through teratologic literature. As a 
distinct and well-authenticated type it has only quite recently been recognized 
by teratologists. 

2. It does not of itself interfere with intrauterine or extrauterine life ; but 
the associated anomalies [c //., atresia ani) may be sources of danger. If not 
noticed at birth, it is not usually discovered till adult life, and even then the 
discovery is commonly accidental. 

3. With regard to the functions of the pelvic viscera, urine may be passed 
by both penises, by one only, or by neither. In the last instance it finds 
exit by an aperture in the perineum. There is reason to believe that semen 
may be passed in the same way; but in most of the recorded cases there has 
been sterility, if not inability to perform the sexual act. 

4. All the degrees of duplication have been met with, from a fissure of 
the glans penis to the presence of two distinct penises inserted at some dis- 
tance from each other in the inguinal regions. 

5. The two penises are usually somewhat defective as regards prepuce, 
urethra, etc. ; they may lie side by side, or more rarely may be situated 
anteroposteriorly ; they may be equal in size, or less commonly one is dis- 
tinctly larger than the other ; and one or both may be perforate or imperforate. 

6. The scrotum may be normal or split ; the testicles, commonly two in 
number, may be normal or atrophic, descended or undescended ; the prostate 
may be normal or imperfectly developed, as may also the vasa deferentia and 
vesiculse seminales. 

7. The commonly associated defects are : More or less completely septate 
bladder, atresia ani, or more rarely double anus, double urethra, increased 
breadth of the bony pelvis with defect of the symphysis pubis, and possibly 
duplication of the lower end of the spine, and hernia of some of the abdom- 
inal contents into a perineal pouch. Much more rarely, duplication of the 
heart, lungs, stomach, and kidneys has been noted, and the lower limbs may 
be shorter than normtd. 

Class XL — Cases of fetus in fetu, those strange instances in which one 
might almost say that a man may be pregnant with his brother or sister, or in 

a 759, 1895. 



-svliich an infant may carry its twin withont tlu' fact l)eino; apparent, will next 
be discussed. The older cases were cited as being only a repetition of the 
process by which Eve was born of Adam. Figure 63 represents an old 
engraving shoAving the birth of Eve. Bartholinus, the Ephemerides, Otto, 
Paullini, Schurig, and Plot speak of instances of fetus in fetu. Ruysch ^ 
describes a tumor contained in the abdomen of a man which was composed 
of hair, molar teeth, and other evidences of a fetus. Huxham reported 
to the Royal Society in 1748 the history of a child which was l)orn with 
a tumor near the anus larger than the whole l^ody of the child ; this tumor 
contained rudiments of an embryo. Young "^ speaks of a fetus which lay 
encysted betAveen the laminae of the transverse mesocolon, and Highmore 
published a report of a fetus in a cyst communicating with the duodenum. 

Dupuytrcn gives an example in a 
boy of thirteen, in whom was found 
a fetus. Gaetano-Xocito, cited by 
Philipeaux,^°- has the history of a 
man of twenty-seven Avho Avas 
taken Avitli a great pain in the 
right hypochondrium, and from 
Avhich issued subsequently fetal 
bones and a mass of macerated 
embryo. His mother had had 
several double pregnancies, and 
from the length of the respecti\"e 
tibiae one of the fetuses seemed to 
be of two months' and the other 
of three months' intrauterine life. 
The man died five years after the 
abscess had burst spontaneously. 
Brodie '^ speaks of a case in Avhich 
fetal remains AA^ere taken from the abdomen of a girl of tAVO and one-half years. 
Gaither ^ describes a child of two years and nine months, supposed to be 
aifected Avith ascites, Avho died three hours after the physician's arriA^al. In 
its abdomen AA'as found a fetus Aveighing almost two pounds and connected 
to the child by a cord resembling an umbilical cord. This child Avas healthy 
for about nine months, and had a precocious longing for ardent spirits, and 
•drank freely an hour before its death. 

Blundell ® says that he knew " a boy Avho Avas literally and Avithout CA'asion 
Avith child, for the fetus Avas contained in a sac communicating Avith the ab- 
domen and Avas co^inected to the side of the cyst by a short uml)ilical cord ; 
nor did the fetus make its appearance until the boy Avas eight or ten years 

a 698, Tome ii. b 550, i., 234. c 550, 3819. 

d 598, 1809, i., 170 et seq. e 476, 1828-1829, 260. 

Fig. 6.3. — Birth of Eve (after an old engraving). 


old, when after much enlargement of pregnancy and subsequent flooding the 
boy died." The fetus, renioved after death, on the whole not very imper- 
fectly formed, was of the size of about six or seven months' gestation. Bury ^ 
cites an account of a child that had a second imperfectly developed fetus in 
its face and scalp. There was a boy by the name of Bissieu'' who from the 
earliest age had a pain in one of his left ribs ; this rib was larger than the rest 
and seemed to have a tumor under it. He died of phthisis at fourteen, and 
after death there was found in a }K)cket lying against the transverse colon 
and communicating with it all the evidences of a fetus. 

At the Hopital de la Charite in Paris, Velpeau startled an audience of 
500 students and many physicians by saying that he expected to find a rudi- 
mentary fetus in a scrotal tumor placed in his hands for operation. His 
diagnosis proved correct, and brought him resounding praise, and all won- 
dered as to his reasons for expecting a fetal tumor. It appears that he had 
read with care a report by Fatti ^ of an operation on the scrotum of a child 
which had increased in size as the child grew, and was found to contain the 
ribs, the vertebral column, the lower extremities as far as the knees, and the 
two orbits of a fetus ; and also an account "^ of a similar operation performed 
by Wendt of Breslau on a Silesian boy of seven. The left testicle in this 
case was so swollen that it hung almost to the knee, and the fetal remains 
removed weighed seven ounces. 

Sulikowski ® relates an instance of congenital fetation in the umbilicus of 
a girl of fourteen, who recovered after the removal of the anomaly. Are- 
tseos described to the members of the medical fraternity in Athens ^ the case 
of a woman of twenty-two, who bore two children after a seven months' preg- 
nancy. One was very rudimentary and only 2J- inches long, and the other 
had an enormous head resembling a case of hydrocephalus. On opening 
the head of the second fetus, another, three inches long, was found in the 
medulla oblongata, and in the cranial cavity with it were tw^o additional 
fetuses, neither of which was perfectly formed. 

Broca ^ speaks of a fetal cyst being passed in the urine of a man of sixty- 
one ; the cyst contained remnants of hair, bone, and cartilage. Atlee ^ sub- 
mits quite a remarkable case of congenital ventral gestation, the subject being 
a girl of six, who recovered after the discharge of the fetal mass from the 
abdomen. Mclntyre ^ speaks of a child of eleven, playing about and feeling 
well, but whose abdomen progressively increased in size IJ inches each day. 
After ten days there was a large fluctuating mass on the right side ; the 
abdomen was opened and the mass enucleated ; it was found to contain a fetal 
mass weighing nearly five pounds, and in addition ten pounds of fluid were 
removed. The child made an early recovery. Rogers J mentions a fetus that 

a 490, 1834. b 302, iv., 179. c 240, 1826. d 240, 1829. 

e 233, 1851-2, 17, 143. f 536, April 16, 1862. 8 362, No. 26, 1868. 

11768, 1879. i 616, Feb., 1894. J 131, 1875. 


was found in a man's bladder. Bouchacourt ^ reports the successful extir- 
pation of the remains of a fetus from the rectum of a child of six. Miner '^ 
describes a successful excision of a congenital gestation. 

Modern literature is full of examples, and nearly every one of the fore- 
going instances could be paralleled from other sources. Rodriguez ^ is quoted 
as reporting that in July, 1891, several newspapers in the city of Mexico 
])ublished, under the head of " A Man-mother," a wonderful story, accom- 
panied by wood-cuts, of a young man from whose body a great surgeon had 
extracted a " perfectly developed fetus." One of these wood-cuts represented 
a tumor at the back of a man opened and containing a crying baby. In 
commenting upon this, after reviewing several similar cases of endocvmian 
monsters that came under his observation in Mexico, Rodriguez tells what 
the case which had been so grossly exaggerated by the lay journals really 
was : An Indian boy, aged twenty-two, presented a tumor in the sacrococ- 
cygeal region measuring 53 cm. in circumference at the base, having a vertical 
diameter of 17 cm. and a transverse diameter of 13 cm. It had no pedicle 
and was fixed, showing unequal consistency. At birth this tumor was about 
the size of a pigeon's egg. A diagnosis of dermoid cyst was made and two 
operations were performed on the boy, death following the second. The 
skeleton showed interesting conditions ; the rectum and pelvic organs were 
natural, and the contents of the cyst verified the diagnosis. 

Quite similar to the cases of fetus in fetu are the instances of dermoid 
cysts. For many years they have been a mystery to physiologists, and their 
orip'in now is little more than hvpothetic. At one time the fact of findino; such 
a formation in the ovary of an unmarried woman was presumptive evidence 
that she was unchaste ; but this idea was dissipated as soon as examples were 
reported in children, and to-day we have a well-defined difference between 
congenital and extrauterine pregnancy. Dermoid cysts of the ovary may 
consist only of a wall of connective tissue lined Avith epidermis and contain- 
ing distinctly epidermic scales which, however, may be rolled up in firm 
masses of a more or less soapy consistency ; this variety is called by Orth 
epidermoid cyst ; or, according to Warren, a form of cyst made up of skin 
containing small and ill-defined papillre, but rich in hair follicles and seba- 
ceous glands. Even the erector pili muscle and the sudoriparous gland are 
often found. The hair is partly free and rolled up into thick balls or is 
still attached to the walls. A large mass of sebaceous material is also found 
in these cysts. Thomson reports a case of dermoid cyst of the bladder con- 
taining hair, which cyst he removed. It was a pedunculated growth, and it 
was undoubtedly vesical and not expelled from some ovarian source through 
the urinary passage, as sometimes occurs. 

The simpler forms of the ordinary dermoid cysts contain bone and teeth. 
The complicated teratoma of this class may contain, in addition to the pre- 

a 368, 1850. b 230, 1874. c 791, April, 1893. 

Plate 3. 

A f-,V 

U \f ^ "^ 

Dermoid cyst laid open, showins; maxillary bone eontaininji teeth ; the head of one of the 
long bones : skin with hair throwing from its surface : serous membrane (probe passed under- 
neath) ; mucous membrane of stomach directly next to serous membrane (Baldy). 



viously mentioned strnctures, cartilage and glands, niucons and serons mem- 
brane, muscle, nerves, and cerebral substance, portions of eyes, fingers with 
nails, mamnifB, etc. Figure 64 represents a cyst containing long red hair 
that was removed from a blonde woman aged forty-four years who had given 
birth to six children. Cullingworth reports the history of a woman in whom 
both ovaries were apparently involved by dermoids, who had given birth to 
12 children and had three miscarriages — the last, three months before the 
removal of the growths. The accompanying illustration (PI. 3), taken 

Fig. 64. — Dermoid cyst containing long red hair, removed from a light-haired woman aged forty-four years 


from Baldy,^ pictures a dermoid cyst of the complicated variety laid open 
and exp<jsing the contents in situ. Mears of Philadelphia reports a case 
of ovarian cyst removed from a girl of six and a half by Bradford of 
Kentucky in 1875. From this age on to adult life many similar cases are 
recorded. Nearly every medical museum has preserved specimens of dermoid 
cysts, and almost all physicians are well acquainted with their occurrence. 
The curious formations and contents and the bizarre shapes are of great 
variety. Graves '^ mentions a dermoid cyst containing the left side of a human 
a " An Americau Text- Book of Gyuecology, " Philadelphia, 1894. b 533, 1895, 212. 



face, an eye, a molar tooth, and varions bones. Dermoid cysts are found also 
in regions of the body quite remote from the ovary. The so-called " orbital 
wens" are true inclusion of the skin of a congenital origin, as are the nasal 
dermoids and some of the cysts of the neck. 

AVeil reported the case of a man of twenty-two years who was born with 
what was supposed to be a spina bifida in the lower sacral region. Accord- 
ing to Senn, the swelling never caused any ])ain oi- inconvenience until it in- 
flamed, when it opened spontaneously and su])purated, discharging a large 
quantity of offensive pus, hair, and sebaceous material, thus proving it to have 
been a dermoid. The cyst was freely incised, and there were found numer- 
ous openings of sweat glands, from which dropi of perspiration escaped when 

the patient was sweating. 

Dermoid cysts of the 
thorax are rare. Bramann 
reported a case in which a 
dermoid cyst of small size 
was situated over th(» ster- 
num at the junction of the 
manubrium with the gladi- 
olus, and a similar cyst in 
the anterior median line of 
the neck near the left cornu 
of the hyoid bone. Chitten 
removed a dermoid from 
the sternum of a female of 
thirty-nine, the cyst con- 
taining 11 ounces of athe- 
romatous material. In the 
^Museum of St. Bartholo- 
mew's Hospital in London 
there is a congenital tumor 
which was removed from the anterior mediastinum of a woman of twenty- 
one, and contained portions of skin, fat, sebaceous material, and two pieces 
of bone similar to the superior maxilla, and in which several teeth were foimd. 
Dermoids are found in the palate and ])harvnx, and open dermoids of the 
conjunctiva are classified by Sutton with the moles. According to Senn, 
Barker collected sixteen dermoid tumors of the tongue. Bryk successfully 
removed a tumor of this nature the size of a fist. AVellington Gray 
removed an enormous lingual dermoid from the mouth of a negro. It con- 
tained 40 ounces of atheromatous material (Fig. 65). Dermoids of the rectum 
are rejiorted. Duvse " reports the history of a case of labor during which a 
rectal dermoid was expelled. Tlie dermoid contained a cerebral vesicle, a 
a La Flautlre Jled., March 14, 1895. 

Fig. Go. — Large lingual dermoid protruding from the moulii 
(after Gray). 


rudimentary eve, a eanine and a molar tooth, and a piece of bone. There 
is little doubt that many cases of fetus in fetu reported were really dermoids 
of the scrotum. 

Ward -' reports the successful removal of a dermoid cyst weighing 30 
pounds from a woman of thirty-two, the mother of two children aged ten and 
twelve, respectively. The report is briefly as follows : " The patient has 
always been in good health until within the last year, during which time 
she has lost flesh and strength quite rapidly, and when brought to my 
hospital by her physician. Dr. James of AAilliamsburg, Kansas, was quite 
weak, although able to walk about the house. A tumor had been growing 
for a number of years, but its growth was so gradual that the patient had 
not considered her condition critical until (piite recently. The tumor 
was diagnosed to be cystoma of the left ovary. Upon opening the sac with 
the trocar we were confronted by complications entirely unlooked for, and 
its use had to be abandoned entirely because the thick contents of the cyst 
w^ould not flow freely, and the presence of sebaceous matter blocked the in- 
strument. As much of the fluid as possible was removed, and the abdominal 
incision was enlarged t<> allow of the removal of the large tumor. An 
ovarian hematoma the size of a large orange was removed from the right 
side. A^e washed the intestines quite as one would wash linen, since some 
of the contents of the cyst had escaped into the abdominal cavity. The ab- 
domen was closed without drainage, and the patient placed in bed without 
experiencing the least shock. Her recovery was rapid and uneventful. She 
returned to her home in four weeks after the operation. 

" The unusual feature in this case was the nature of the contents of the sac. 
There was a large quantity of long straight hair growing from the cyst wall 
and an equal amount of loose hair in short pieces floating through the tumor- 
contents, a portion of which formed nuclei for what were called ' moth-balls,' 
of which there were about 1|^ gallons. These balls, or marbles, varied from 
the size of moth-balls, as manufactured and sold by druggists, to that of small 
walnuts. They seemed to be composed of sebaceous matter, and were evi- 
dently formed around the short hairs by the motion of the fluid produced by 
walking or riding. There was some tissue resembling true skin attached to 
the inner wall of the sac." 

There are several cases of multiple dermoid cysts on record, and they 
may occur all over the body. Jamieson ^ reports a case in which there were 
250, and in ]\Iaclaren's case there w^ere 132. According to Crocker, Hebra 
and Rayer also each had a case. In a case of Sangster, reported by Politzer, 
although most of the dermoids, as usual, were like fibroma-nodules and 
therefore the color of normal skin, those over the mastoid processes and 
clavicle were lemon-yellow, and w^ere generally thought to be xanthoma 
until they were excised, and Politzer found they were typical dermoid cysts 
w ith the usual contents of degenerated epithelium and hair. 

a Interuat. Med. Magaz., Pliila., Julj-, 1895. ^ 318, Sept., 1873, 223. 


Hermaphroditism. — Some writers claim that Adam was the first herma- 
phrodite and support this by Scriptural evideuce/'* We fiud in some of the 
ancient poets traces of an Egyptian legend in which the goddess of the moon 
was considered to be both male and female. From mythology we learn that 
Hermajihroditus was the son of Hermes, or Mercury, and Venus Aphrodite, 
and had the powers both of a father and mother. In speaking of the fore- 
going Ausonius writes, " Cujus erat facies in qua paterque materque 
cognosci possint, nomen traxit ab illis." Ovid and Virgil both refer to 
legendary hermaphrodites, and the knowledge of their existence was preva- 
lent in the olden times. The ancients considered the birth of hermaphro- 
dites bad omens, and the Athenians threw them into the sea, the Romans, 
into the Tiber. Livy speaks of an hermaphrodite being put to death in 
Umbria, and another in Etruria. Cicero, Aristotle, Strabonius, and Pliny all 
speak concerning this subject. Martial "^ and Tertullian noticed this anomaly 
among the Romans. Aetius and Paulus yEgineta speak of females in Egypt 
with prolonged clitorides which made them appear like hermaphrodites. 
Throughout the Middle Ages we frequently find accounts, naturally exagger- 
ated, of double-sexed creatures. Harvey, Bartholinus, Paullini, Schenck, 
AVolif, Wrisberg, Zacchias, Marcellus Donatus, Haller, Hufeland, de Graif, 
and many others discuss hermaphroditism. ]Many classifications have been 
given, as,'<'. _r/., real and apparent ; masculine, feminine, or neuter; horizontal 
and vertical ; unilateral and bilateral, etc. The anomaly in most cases 
consists of a malformation of the external genitalia. A prolonged clitoris, 
prolapsed ovaries, grossness of figure, and hirsute apj^earance have been 
accountable for many supposed instances of hermaj^hrodites. On the other 
hand, a cleft scrotum, an ill-developed penis, perhaps hypospadias or epispa- 
tlias, rotundity of the mammee, and feminine contour have also provoked 
accounts of similar instances. Some cases have been proved by dissection to 
have been true hermaphrodites, portions or even entire genitalia of l^oth sexes 
having l)een found. 

Numerous accounts, many mythical, but always interesting, are given of 
these curious persons. They have been accredited with having performed 
the functions of both father and mother, notwithstanding the statements of 
some of the best authorities that they are always sterile. Observation has 
shown that the sexual appetite diminishes in proportion to the imperfections 
in the genitalia, and certainly many of these persons are sexually indifierent, 

AVc give descriptions of a few of the most famous or interesting instances 
of hermaphroditism. Pare ^ speaks of a woman who, Ijesides a vuha, from 
which she menstruated, had a penis, l)ut without prepuce or signs of erectility. 
Haller alludes to several cases in which pr(^l(^nged clitorides have l^een the 
cause of the anomaly. In commenting on this form of hermaphroditism Albu- 
casius ^'^ describes a necessary operation for the removal of the clitoris. 

a Genesis, chap, i., verse 27. b 509, HI). 1, ej). 91. c q\s, L. xxv., chap. vi. 


Columbus ^ relates the history of an Ethiopian woman who was evidently a 
spurious female hermaphrodite. The poor wretch entreated him to cut off 
her penis, an enlarged clitoris, which she said was an intolerable hindrance 
to her in coitus. De Graff and Riolan describe similar cases. There is 
an old record of a similar creature, supposing herself to be a male, who took 
a wife, but previously having had connection with a man, the outcome of 
which was pregnancy, was shortly after marriage delivered of a daughter. 
There is an account '^ of a person in Germany who, for the first thirty years 
of life, was regarded as feminine, and being of loose morals became a mother. 
At a certain period she began to feel a change in her sexual inclinations ; she 
married and became the fiither of a family. This is doubtless a distortion 
of the facts of the case of Catherine or Charles Hoffman, born in 1824, 
and who was considered a female until the age of Ibrty. At puberty she 
had the instincts of a woman, and cohabitated with a male lover for twenty 
years. Her breasts were well formed and she menstruated at nineteen. At 
the age of forty-six her sexual desires changed, and she attempted coitus as 
a man, with such evident satisfaction that she married a woman soon after- 
ward. Fitch speaks of a house-servant ^' with masculine features aud move- 
ments, aged twenty-eight, and 5 feet and 9 inches tall, who was arrested l)y 
the police for violating the laws governing prostitution. On examination, 
well-developed male and female organs of generation were found. The 
labia maj(n^a were normal and flattened on the anterior surface. The labia 
minora and hymen were absent. The vagina was spacious and the woman 
had a profuse leukorrhea. She stated that several years previously she 
gave birth to a normal child. In place of a clitoris she had a penis which, 
in erection, measured b\ inches long and 3f inches in circumference. The 
glans penis and the urethra were perfectly formed. The scrotum contained 
two testicles, each about an inch long ; the mons veneris Avas sparsely covered 
with straight, black hair. She claimed functional ability with both sets of 
genitalia, and said she experienced equal sexual gratification with either. 
Semen issued from the penis, and every three weeks she had scanty menstrua- 
tion, which lasted but two days. 

Beclard*! showed Marie-Madeline Lefort, nineteen years of age, IJ 
meters in height. Her mamm» were well developed, her nipples erectile 
and surrounded by a brown areola, from which issued several hairs. Her 
feet were small, her pelvis large, and her thighs like those of a woman. 
Projecting from the vulva was a body looking like a penis 7 cm. long 
and slightly erectile at times ; it was imperforate and had a mobile prepuce. 
She had a vulva with two well-shaped labia as shown l)y the accompanying 
illustration (Fig. 66). She menstruated slightly and had an opening at the 
root of the clitoris. The parotid region showed signs of a beard and she had 

a De re anatomica, L. xxv. ^ 224, 1889, i., 1038. 

c 597, Nov. 22, 1890. dpaculte de Med. de Paris, 1815. 



hair on her upper lip. On August 20, 1864, a person came into the Hotel- 
Dieu, asking treatment for chronic pleurisy. He said his age was sixty-five, 
and he })ursued the calling of a mountebank, but remarked that in early life 
he had been taken for a woman. He had menstruated at eight and had 
been examined by doctors at sixteen. The menstruation continued until 
184<S, and at its cessation he experienced the feelings of a male. At 
this time he presented tlie venerable appearance of a long-bearded old man 
(Fig. 67). At the autopsy, about two months later, all the essentials of 
a female were delineated. A Fallopian tube, ovaries, uterus, and round 
ligaments were found, and a drawing in cross-section of the parts was 

Fig. 66. — Marie-Madeline Lefort at sixteen 
years of age. 

Fig. 67. — Marie-Madeline Lefort at sixty- 
live years of a>;e. 

made (Fig. 68). There is no doubt but that this individual was ]\Iarie- 
]\ladeline Lefort in age. 

Worbe ^ speaks of a person who was supposed to be feminine for twenty- 
two years. At the age of sixteen she loved a farmer's son, but the union 
was delayed for some reason, and three years later her grace ^ faded and she 
became masculine in her looks and tastes. It was only after lengthy discus- 
sion, in which the court took part, that it was definitely settled that this 
person w^as a male. 

Adelaide Preville, ""^^ who was married as a female, and as such lived the 
last ten years of her life in France, was found on dissection at the Hotel- 

a 461, Jau. et Fev., 1816. 



Dieu to be a man. A man was spoken of in both France and Gerijiany * 
who passed for many years as a female. He had a cleft scrotum and hypo- 
spadias, which caused the deception. Sleeping with another servant for three 
years, he constantly had sexual congress with her during this period, and 
tinallv impregnated her. It was supposed in this case that the posterior wall 
of the vagina supplied the deficiency of the lower boundary of the urethra, 
forming a complete channel for the semen to proceed through. Long ago in 
Scotland ^^- a servant was condemned to death by burial alive for impregnat- 
ing his master's daughter while in the guise and habit of a woman. He had 
always been considered a woman. AVe have heard of a recent trustworthy 
account of a pregnancy and delivery in a girl who had been impregnated by 
a bed-fellow who on examina- 
tion proved to be a male pseu- 

Fournier '^ speaks of an in- 
dividual in Lisbon in 1807 
who was in the highest de- 
gree of perfection, both male 
and female. The figure was 
graceful, the voice feminine, 
the mammae well developed, 
and menstruation was regular. 
The female genitalia were nor- 
mal except the laljia majora, 
which were rather diminutive. 
The thighs and the pelvis 
were not so wide as those of a 
woman. There was some beard 
on the chin, but it was worn 
close. The male genitalia were 
of the size and appearance of 

a male adult and were covered with the usual hair. This person had been 
twice pregnant and aborted at the third and fifth month. During coitus the 
penis became erect, etc. 

Schrell ^ describes a case in which, independent of the true penis and tes- 
ticles, which were well formed, there existed a small vulva furnished with 
labia and nymphne, communicating with a rudimentary uterus provided 
with round ligaments and imperfectly developed ovaries. Schrell remarks 
that in this case we must notice that the female genitalia were imperfectly 
developed, and adds that perfect hermaphroditism is a physical impossibility 
without o-reat alterations of the natural connections of the bones and other 

Fig. 68. — Mesial section sliowing the generative organs of 
Marie-Madeline Lefort. The sound is introduced into the 
vagina, and from thence into the orifice of the urethra; U, the 
uterus; 0, the ovary and Fallopian tube. 

a 789, Aug. 26, 18.">6. 

b 302, iv., 164. 

c Med.-Chir. prakt. Archiv von Bader, etc., i., 1804, 




parts of the pelvis. Cooper =* describes a woman with an enormous develop- 
ment of the clitoris, an imperforate uterus, and al)sence of vagina ; at first 
sight of the parts they appeared to be those of a man. 

In 1859 Hugier succeeded in restoring a vagina to a young girl of twenty 
who had an hypertrophied clitoris and no signs of a vagina. The accom- 
panying illustrations show the conformation of the parts before operation 
Avith all the appearance of ill-developed male genitalia, and the appearance 
afterward with restitution of the vaginal opening (Fig. 69). 

Vircliow in 1872, Boddaert in 1875, and Marchand in 1883 report cases 
of duplication of the genitalia, and call their cases true hermaphrodites from 
an anatomic standpoint. There is a specimen in St. Bartholomew's Hospital 
in London from a man of forty-four, who died of cerebral hemorrhage. He 

Fig. 69. — Occlusion of tlie vulva and hypertrophy of the clitoris, before and after operation ; B, sound introduced 
into a narrow vulvar orifice ; C, labium majus containing an ovary ; D, urinary meatus. 

was well formed and had a beard and a full-sized penis. He was married, 
and it was stated that his wife had two children.^' The liladder and the in- 
ternal organs of generation were those of a man in whom neither testis had 
.descended into the scrotum, and in whom the uterus masculinus and vagina 
were developed to an unusual degree. The uterus, nearly as large as in the 
adult female, lay between the l)ladder and rectum, and was enclosed between 
two layers of peritoneum, to which, on either side of the uterus, were attached 
the testes. There was also shown ''^'' in London the pelvic organs from a case 
of complex or vertical hermaphroditism occurring in a child of nine months 
who died from the effects of an operation for the radical cure of a right ii.- 
guinal hernia. The external organs were those of a male with undescended 
a 392, 1840, 243. ^ 779, xliv., 102. 

Plate 4- 

\ ^^ 



Pseudo-external bilateral hermaphroditism (Krug). 


testes. The bladder was normad and its neck was surrounded by a prostate 
gland. Projecting backward were a vagina, uterus, and broad ligaments, 
round ligaments, and Fallopian tubes, with the testes in the position of the 
ovaries. There Avere no seminal vesicles. The child died eleven days after 
the operation. Tlie family history states that the mother had had 14 chil- 
dren and eight miscarriages. Seven of the children were dead and showed 
no abnormalities. The fifth and sixth children were boys and had the same 
sexual arrangement. 

Barnes, Chalmers, Sippel, and Litten describe cases of spurious herma- 
phroditism due to elongation of the clitoris. In Litten's case "■ the clitoris 
was 3J inches long, and there was hydrocele of the processus vaginalis on 
both sides, making tumors in the labium on one side and the inguinal 
canal on the other, which had been diagnosed as testicles and ayain as 
ovaries. There was associate cystic ovarian disease. Plate 4 is taken from 
a case of false external bilateral hermaphroditism. Phillips '^ mentions four 
cases of spurious hermaphroditism in one family, and recently Pozzi "^ tells of 
a family of nine individuals in whom this anomaly was observed. The first 
was alive and had four children ; the second was christened a female but was 
proba1)ly a male ; the third, fourth, and fifth were normal but died young ; 
the sixth daughter was choreic and feeble-minded, aged twenty-nine, and had 
one illegitiniate child ; the seventh, a boy, Avas healthy and married ; the 
eighth iCas christened a female, but when seventeen was declared by the 
Faculty to be a male ; the ninth was christened a female, but at eigliteen the 
genitals were found to be those of a male, though the mammse were well 

O'Neill '^ speaks of a case in which the clitoris was five inches long and one 
inch thick, having a groove in its inferior surface reaching down to an oblique 
opening in the perineum. The scrotum contained two hard bodies thought to 
be testicles, and the general appearance was that of hypospadias. Postmortem 
a complete set of female genitalia was found, although the ovaries were very 
small. The right round ligament w^as exceedingly thick and reached down to 
the bottom of the false scrotmji, where it was firmly attached. The hard 
bodies pro\ed to be on one side an irreducible omental hernia, probably con- 
genital, and on the other a hardened mass having no glandular structure. 
The patient was an adtilt. As we have seen, there seems to be a law of 
evolution in hermgf]phroditism which prevents perfection. If one set of 
genitalia are exfraordinarily developed, the other set are corres])ondingly 
atrophied. Yn the case of extreme development of the clitoris and approxi- 
mation to the male tyj/e we must expect to find imperfectly developed uterus 
or ovtlries. This <\-ould answer for one of the causes of sterility in these 

There is a type of hermaphroditism in which the sex cannot be definitely 

a 161, Ixxv. b 778, xxviii., 158. c 368, 1885, ii., 109. '1104^1(^51^588. 


declared, and sometimes dissection does not definitely indicate the predomi- 
nating sex. Snch cases are classed under the head of neuter hermaphro- 
dites, possibly an analogy of the " genus epiccenuni " of Ciuintilian, Marie 
Dorothe'e, of the age of twenty-three, was examined and declared a girl by 
Hufeland and Mursina, while Stark, Raschig, and Martens maintained that 
she Avas a boy. This formidable array of talent on both sides provoked 
much discussion in contemporary publications, and the case attracted much 
notice. Marc saw her in 1803/ at which time she carried contradicting 
certificates as to her sex. He found an imperforate penis, and on the in- 
ferior face near the root an o^^ening for the passage of urine. No traces of 
nymphse, vagina, testicles, nor beard were seen. The stature was small, the 
form debilitated, and the voice eifeminate. Marc came to the conclusion 
tliat it Avas impossible for any man to determine either one sex or the other. 
Everard Home dissected a dog with apparent external organs of the female, 
but discovered that neither sex was sufficiently pronounced to admit of classi- 
fication. Home also saw at the Royal Marine Hospital at Plymouth, in 
1779, a marine who some days after admission was reported to be a girl. 
On examination Home found him to possess a weak voice, soft skin, volum- 
inous breasts, little beard, and the thighs and legs of a woman. There was 
fat on the pubis, the penis was short and small and incapable of erection, the 
testicles of fetal size ; he had no venereal desires whatever, and as regards sex 
was virtually neuter. 

The legal aspect of hermaphroditism has always been much discussed. 
Many interesting questions arise, and extraordinary complications naturally 
occur. In Rome a hermaphrodite could be a witness to a testament, the ex- 
clusive privilege of a man, and the sex was settled by the predominance. If 
the male aspect and traits together with the generative organs of man were 
most pronounced, then the individual could call himself a man. " Hermapliro- 
ditus an ad testamentum adhiberi possit qualitas sexus incalescentis ostendit." 

There is a peculiar case on record ^ in which the question of legal male 
inheritance was not settled until the individual had lived as a female for fifty- 
one years. This person was married when twenty-one, but finding coitus 
impossible, separated after ten years, and though dressing as a female had 
coitus with otlier women. She finally lived with her brother, with whom she 
eventually came to blows. She prosecuted him for assault, and the brother 
in return charged her with seducing his Avife. Examination ensued, and at 
this ripe age she was declared to be a male. 

The literature on hermaphroditism is so extensive that it is impossible to 
select a proper representation of the interesting cases in this limited space, 
and the reader is referred to the modern French works on this subject, in 
which the material is exhaustive and the discussion thoroughly scientific. 

a 302, xxi., 104. b 359, July 29, 1895. 


Ancient Ideas Relative to Minor Terata. — Tlie ancients viewed Avitli 
great interest tlie minor structural anomalies of man, and held them to be 
divine signs or warnings in much the same manner as they considered more 
pronounced monstrosities. In a most interesting and instructive article, 
Ballantyne ^ quotes Ragozin in saying that the Chaldeo-Babylonians, in addi- 
tion to their other numerous subdivisions of divination, drew presages and 
omens for good or evil from the appearance of the liver, bowels, and viscera 
of animals offered for sacrifice and opened for inspection, and from tlie 
natural defects or monstrosities of babies or the young of animals. Ballan- 
tyne names this latter subdivision of divination fetomancy or teratoscopy, 
and thus renders a special chapter as to omens derived from monstrous 
births, given by Lenormant : — 

" The prognostics which the Chaldeans claimed to draw from monstrous 
births in man and the animals are worthy of forming a class by themselves, 
insomuch the more as it is the part of their divinatory science with which, 
up to the present time, we are best acquainted. The development that their 
astrology had given to ' genethliaque,' or tlie art of horoscopes of births, 
had led them early to attribute great importance to all the teratologic facts 
which were there produced. They claimed that an experience of 470,000 
years of observations, all concordant, fully justified their system, and that in 
nothing was the influence of the stars marked in a more indubitable manner 
than in the fatal law which determined the destiny of each individual 
according to the state of tlie skv at the nKjment when he came into the 
world. Cicero, l)y the very terms which he uses to refute the Chaldeans, 
shows that the result of these ideas was to consider all infirmities and mon- 
strosities that new-born infants exhibited as the inevitable and irremediable 
consequence of the action of these astral positions. This being granted, the 
observation of similar monstrosities gave, as it were, a reflection of the state 
of the sky, on which depended all terrestrial things ; consequently, one might 
read in them the future with as much certainty as in the stars themselves. 
For this reason the greatest possible importance was attached to the terato- 
logic auguries which occupy so much space in the fragments of the great 

a 759, i., 127. 



treatise on terrestrial presages which have up to the present time been pub- 

The rendering- into English of the account of 62 teratologic cases in the 
human subject with the prophetic meanings attached to them by Chaldean 
diviners, after the translation of Opport, is given as follows by Ballantyne, 
some of the words being untranslatable : — 

"When a woman gives birth to an int'aut — 

(1 ) that has the ears of a lion, there will be a ]>owerful king in the country ; 

(2) that wants the right ear, the days of the master (king) will be ])rolonged (reach old age) ; 

(3) that wants both ears, there will be mourning in the country, and the country will be 

lessened (diminished) ; 

(4) whose right ear is small, the house of the man (in whose house the birth took place) 

will be destroyed ; 

(5) whose ears are both small, the house of the man will be built of bricks ; 

(6) whose right ear is mudissu teliaat (monstrous), there will be an androgyne in the house 

of the new-born ; 

(7) whose ears are both much'ssit (deformed), the country will perish and the enemy rejoice ; 

(8) whose right ear is round, there will be an androgyne in the house of the new-born ; 

(9) whose right ear has a wound below, and tur re ut of the man, the house will be 

destroyed ; 

(10) that has two ears on the right side and none on the left, the gods will bring about a 

stable reign, the country will flourish, and it will be a land of repose ; 

(11) whose ears are both closed, sa a au ; 

(12) that has a bird's beak, the country will be peaceful ; 

(13) that has no mouth, the mistress of the house will die ; 

(14) that has no right nostril, the peoi)le of the world will be injured ; 

(15) whose nostrils are absent, the country will be in aflJiction, and the house of the man 

will be ruined ; 
(Ifi) whose jaws are absent, the days of the master (king) will be prolonged, but the house 
(where the infant is born) will be iTiined. 

When a woman gives birth to an infant — 

(17) that has no lower jaw, mnt ta at mat, the name will not be effaced ; 

(20) that has no nose, affliction will seize upon the country, and the master of the house 

will die ; 

(21) that has neither nose nor virile member (penis), the army of the king will be strong, 

peace will be in the land, the men of the king will be sheltered from evil influences, 
and Lilit (a female demon) shall not have power over them ; 

(22) whose upper lip overrides the lower, the people of the world will rejoice (or good 

augury for the troops) ; 

(23) that has no lips, affliction will seize ujwn the land, and the house of the man will be 

destroyed ; 

(24) whose tongue is Jiuri aat, the man will be spared C^*) ; 

(25) that has no right hand, the country will be convulsed by au earthquake ; 

(26) that has no fingers, the town will have no births, the har shall be lost ; 

(27) that has no fingers on the right side, the master (king) will not pardon his adversary 

{or shall be humiliated by his enemies) ; 

(28) that has six fingers on the right side, the man will take tlie hilcrnni of the house ; 

(29) that has six very small toes on both feet, he shall not go to the Inkunu ; 

(30) that has six toes on each foot, the people of the world will be injured (calamity to the 

troops) ; 


(31) that has the heart open and that has no skin, the country will suffer from calamities ; 

(32) that has no penis, the master of the house will be enriched by the harvest of liis field ; 

(33) that wants the penis and the umbilicus, there will be ill-will in the house, the woman 

(wife) will have an overbearing eye (be haughty) ; but the male descent of the 
palace will be more extended. 

When a woman gives birth to an infant — 

(34) that has no well-marked sex, calamity and affliction will seize upon the land ; the 

master of the house shall have no happiness ; 

(35) whose anus is closed, the country will suffer from want of nourishment ; 

(36) whose right testicle (?) is absent, the country of the master (king) will perish ; 

(37) whose right foot is absent, his house will be ruined and there will be abundance in 

that of the neighbor ; 

(38) that has no feet, the canals of the country will be cut (intercepted) and the house 

mined ; 

(39) that has the right foot in the form of a fish's tail, the booty of the country of the 

humble will not be imas sa hir ; 

(40) whose hands and feet are like four fishes' tails (fins), the master (king) shall perish (?) 

and his country shall be consumed ; 

(41) whose feet are moved by his great hunger, the house of the su su shall be destroyed ; 

(42) whose foot hangs to the tendons of the body, there will be great prosperity in the 

land ; 

(43) that has three feet, two in their normal position (attached to the body) and the third 

between them, there will be great prosperity in the land ; 

(44) whose legs are male and female, there will be rebellion ; 

(45) that wants the right heel, the country of the master (king) will be destroyed. 

When a woman gives birth to an infant — 

(46) that has many white hairs on the head, the days of the king will be prolonged ; 

(47) that has much Ipga on the head, the master of the house will die, the house will be 

destroyed ; 

(48) that has much pinde on the head, joy shall go to meet the house (that has a head on 

the head, the good augury shall enter at its aspect into the house) ; 

(49) that has the head full of hall, there will be ill-will toward him and the master (king) 

of the town shall die ; 

(50) that has the head full of dksi, the king will repudiate his masters ; 

(51) that has some pieces of flesh (skin) hanging on the head, there shall be ill-will ; 

(52) that has some branches (?) (excrescences) of flesh (skin) hanging on the head, there 

shall be ill-will, the house will perish ; 

(53) that has some formed fingei's (horns?) on the head, the days of the king will be less 

and the years lengthened (in the duration of his old age) ; 

(54) that has some hali on the head, there will be a king of the land ; 

(55) that has a of a bird on the head, the master of the house shall not prosper ; 

(56) that has some teeth already through (cut), the days of the king will arrive at old age, 

the country will show itself powerful over (against) strange (feeble) lands, but the 
house where the infant is born will be ruined ; 

(57) that has the beard come out, there will be abundant rains ; 

(58) that has some hirta on the head, the country will be strengthened (reinforced) ; 

(59) that has on the head the mouth of an old man and that foams (slabbers), there will be 

great prosperity in the land, the god Bin will give a magnificent harvest (inundate 
the land with fertility), and abundance shall be in the land ; 

(60) that has on one side of the head a thickened ear, the first-born of the men shall five 

a long time (?) ; 


(61) that has on the head two long and thick ears, there will be tranquility and the pacifi- 

cation of litigation (contests) ; 

(62) that has the figure in horn (like a horn ?) . . . " 

As ancient and as obscure as are these records, Ballantyne has carefully 
gone over each, and gives the following lucid explanatory comments : — 

"What 'ears like a lion' (No. 1) may have been it is difficult to determine ; but doubt- 
less the direction and shape of the auricles were so altered as to give them an animal 
appearance, and possibly the deformity was that called ' orechio ad ansa ' by Lombroso. 
The absence of one or both ears (Nos. 2 and 3) has been noted in recent times by Virchow 
(Archiv fur path. Anat., xxx., p. 221), Gradenigo (Tarufl&'s ' Storia della Teratologia,' vi., 
p. 552), and others. Generally some cartilaginous remnant is found, but on tliis point the 
Chaldean record is silent. Variations in the size of the ears (Nos. 4 and 5) are well known 
at the present time, and have been discussed at length by Binder (Archiv fiir Psychiatrie 
und Nervenkrankheiten, xx., 1887) and others. The exact malformation indicated in 
Nos. 6 and 7 is, of course, not to be determined, although further researches in Assyriology 
may clear up this point. The 'round ear' (No. 8) is one of Binder's types, and that 
with a ' wound below ' (No. 9) probably refers to a case of fistula auris congenita (Toyn- 
bee, 'Diseases of the Ear,' 1860). The instance of an infant born witii two ears on the 
right side (No. 10) was doubtless one of cervical auricle or preauricular appendage, whilst 
closure of the external auditory meatus (No. 11) is a well-known deformity. 

"The next thirteen cases (Nos. 12-24) were instances of anomalies of the mouth and 
nose. The 'bird's beak' (No. 12) may have been a markedly aquiline nose; No. 13 was 
a case of astoma ; and Nos. 14 and 15 were instances of stenosis or atresia of the anterior 
nares. Fetuses with absence of the maxillfe (Nos. 16 and 17) are in modern terminology 
called agnathous. Deformities like that existing in Nos. 20 and 21 have been observed in 
paracei^halic and cyclopic fetuses. The coincident absence of nose and penis (No. 21) is 
interesting, especially when taken in conjunction with the popular belief that the size of the 
former organ varies with that of the latter. Enlargement of the upper lip (No. 22), called 
epimacrochelia by Tarufii, and absence of the lips (No. 23), known now under the name of 
brachychelia, have been not unfrequently noticed in recent times. The next six cases (Nos. 
25-30) were instances of malformations of the upper limb : Nos. 25, 26. and 27 were prob- 
ably instances of the so-called spontaneous or intrauterine amputation ; and Nos. 28, 29, 
and 30 were examples of the comj^aratively common deformity known as polj'dactyly. No. 
31 was probably a case of ectopia cordis. 

"Then follow five instances of genital abnormalities (Nos. 32-36), consisting of absence 
of the ]ienis (epispadias?), absence of penis and umbilicus (epispadias and exomphalos ?), 
hermajihroditism, imperforate anus, and nondescent of one testicle. The nine following 
cases (Nos. 37-45) were anomalies of the lower limbs : Nos. 37, 38, and 42 may have been 
spontaneous amputations ; Nos. 39 and 40 were doubtless instances of webbed toes (sj'n- 
dactyly), and the deformity indicated in No. 45 was presumably talipes equinus. The 
infant born with three feet (No. 43) was possibly a case of parasitic monstrosity, several of 
which have been reported in recent teratologic literature ; but what is meant by the state- 
ment concerning ' male and female legs ' it is not easy to determine. 

"Certain of the ten fjllowing prodigies (Nos. 46-55) cannot in the present state of our 
knowledge be identified. The presence of congenital patches of white or gray hair on the 
scalp, as recorded in No. 46, is not an unknown occurrence at the present time ; but what 
the Chaldeans meant by ijyga^ pinde, hali, siksi, and kali on the head of the new-born 
infant it is impossible to tell. The guess may be hazarded that cephalhematoma, hydro- 
cephalus, meningocele, nevi, or an excessive amount of vernix caseosa were the conditions 
indicated, but a wider acquaintance with the meaning of the cuneiform characters is neces- 
sary before any certain identification is possible. The ' pieces of skin hanging from the 


head' (No. 51) may have been fragments of the membranes ; but there is nothing in the 
accompanying prediction to help us to trace the origin of the popular belief in the good luck 
following the baby born with a caul. If No. 53 was a case of congenital horns on the head, it 
must be regarded as a unique example, unless, indeed, a form of fetal ichthyosis be indicated. 
"The remaining observations (No. 56-62) refer to cases of congenital teeth (No. 56), 
to deformity of the ears (Nos. 60 and 61), and a horn (No. 62)." 

From these early times almost to the present day similar significance has 
been attached to minor structural anomalies. In the following pages the 
individual anomalies will be discussed separately and the most interesting 
examples of each will be cited. It is manifestly evident that the object of 
this chapter is to mention the most striking instances of abnorniism and to 
give accompanying descriptions of associate points of interest, rather than to 
offer a scientific exposition of teratology, for which the reader is referred 

Congenital defect of the epidermis and true skin is a rarity in 
patiiology. Pastorello " speaks of a child which lived for two and a half 
hours wliose hands and feet were entirely destitute of epidermis ; the true 
skin of those parts looked like that of a dead and already putrefying child. 
Hanks '' cites the history of a case of antepartum desquamation of the skin 
in a living fetus. Hochstetter *= describes a full-terra, living male fetus with 
cutaneous defect on both sides of the abdomen a little above the umbilicus. 
The placenta and meml)ranes were normal, a fact indicating that the defect 
was not due to amniotic adhesions ; the child had a club-foot on the left side. 
The mother had a fall three weeks before labor. 

Abnormal Elasticity of the Skin. — In some instances the skin is 
affixed so loosely to the underlying tissues and is possessed of so great elas- 
ticity that it can be stretched almost to the same extent as India rubber. 
There have been individuals who could take the skin of the forehead and 
pull it down over the nose, or raise the skin of the neck over the moutli. 
They also occasionally have an associate muscular development in the sul)- 
cutaneous tissues similar to the panniculus adiposus of quadrupeds, giving 
them preternatural motile power over the skin. The man recently exhibited 
under the title of the '' Elastic-Skin Man " was an example of this anomaly. 
The first of this class of exhibitionists was seen in Buda-Pesth some years 
since and possessed great elasticity in the skin of his whole body ; even his 
nose could be stretched. Figure 70 represents a photograph of an exhibi- 
tionist named Felix Wehrle, who besides having tlie power to stretch his skin 
could readily bend his fingers backward and forward. The photogra])h was 
taken in January, 1888. 

In these congenital cases there is loose attachment of the skin without 
hypertrophy, to which the term dermatolysis is restricted by Crocker. Job 
van ^Nleekren,'^''''^ the celebrated Dutch i)hysician of the seventeenth century, 

a 153, July, 1845. b 125, 1880, 595. c 263, 1894, 542. 



states that in KjoT a Spaniard, Georgius Albes, is reported to have been able 
to draw the skin of the left pectoral region to the left ear, or the skin under 
the face over the chin to the vertex. The skin over the knee could be 
extended half a yard, and when it retracted to its normal position it was not 
in folds. Seiifert examined a case of this nature in a young man of nineteen, 
and, contrary to Kopp's supposition, found that in some skin from over the 
left second rib the elastic fillers were quite normal, but there was transforma- 
tion of the connective tissue of the dermis into an unformed tissue like a 

myxoma, with total disappearance of the 
connective-tissue bundles. Laxity of 
the skin after distention is often seen in 
multipara, both in the breasts and in the 
abdominal walls, and also from obesity, 
but in all such cases the skin falls in 
folds, and does not have a normal appear- 
ance like that of the true "elastic-skin 

Occasionally abnormal development 
of the scalp is noticed. McDowall ^ 
records an instance in an epileptic idiot 
of twenty-two. On each side of the 
median line of the head there were five 
deep furrows (Fig. 71), more curved and 
shorter as the distance from the median 
line increased. In the illustration the 
hair in the furrows is left longer than 
that on the rest of the head. The patient 
was distinctly microcephalic and the 
right side of the body was markedly 
wasted. The folds were due to hyper- 
trophy of the muscles and seal]), and the 
same sort of furrowing is noticed when 
a dog " pricks his ears." This case may 
possibly be considered as an example of reversion to inferior types. Cowan ^ 
records two cases of the foregoing nature in idiots. The first case (Fig. 72) 
was a paralytic idiot of thirty-nine, whose cranial development was small in 
proportion to the size of the face and ])ody ; the cranium was oxycephalic ; the 
scalp was lax and redundant and the hair thin ; there were 13 furrows, five on 
each side running anteroposteriorly, and three in the occipital region running 
transversely. The occipitofrontalis muscle had no action on tliem. The 
second case was that of an idiot of forty-four of a more degraded type than 
the previous one. The cranium was round and bullet-shaped and the hair 
a 465, Jan., 1893.' b 465, Oct., 1893. 

Fig. 70. — An " el;i'itic-ski]i uiaii. 



generally thick. The scalp ^vas not so lax as in the other case, but the 
furrows were more crooked. By tickling the scalp over the back of the 
neck the two median furrows involuntarily deepened. 

Impervious Skin. — There have been individuals who claimed that tlieir 
skin Avas impervious to ordinary puncture, and from time to time these indi- 
viduals have appeared in some of the larger medical clinics of the world for 
inspection. According to a recent number of the London Graphic, there is 
in Berlin a Singhalese who baffles all investigations by physicians by the 
impenetrability of his skin. The bronzed Easterner, a Hercules in shape, 
claims to have found an elixir which will render the human skin impervious 
to any metal point or shar])ened edge of a knife or dagger, and calls himself 
the '' ^lan with Iron Skin." He is now exhil)iting liimself, and his greatest 
feat is to pass with his entire body through a hoop the inside of which is hardly 

Fig. 71.— Abnormal development of scalp (McDowall). 

Fig. 72. — Abnormal development of scalp (Cowan). 

big enough to admit his body and is closely set with sharp knife-points, dag- 
gers, nails, and similar things. Through this hoop he squeezes his body with 
absolute impunity. The physicians do not agree as to his immunity, and 
some of them think that Rhaimin, which is his name, is a fakir who has by 
long practice succeeded in hardening himself against the impressions of 
metal upon his skin. The professors of the Berlin clinic, however, consid- 
ered it worth while to lecture about the man's skin, pronauncing it an inex- 
plicable matter. This individual performed at the London Alhambra in the 
latter part of 1895. Besides climbing with bare feet a ladder whose rungs 
were sharp-edged swords, and lying on a bed of nail points with four men 
seated upon him, he curled himself up in a l)arrel, through wliose inner edges 
nails projected, and was rolled al)Out the stage at a rapid rate. Emerging 
from thence uninjured, he gracefully bows himself oil" the stage. 



Some individuals claim immunity from burns and show many interesting 
feats in handling- fire. As they are notliing' but skilful "fire jugglers" they 
deserve no mention here. The innnunity of the participants in the savage 
fire ceremonies will l)e discussed in Chapter IX. 
J Albinism is characterized by the al)solute or relative absence of pigment 
of tiie skin, due to an arrest, insufticiency, or retardation of this pigment. 
Following Trelat and Guinard, we may divide albinism into two classes, — 

general and partial. 

As to the etiology of 
albinism, there is no 
known cause of the com- 
plete form. Heredity 
plays no part in a num- 
ber of cases investigated 
1 »y the authors. D'Aube, 
by his observations on 
white rabbits, believes 
that the influence of con- 
sanguinity is a marked 
factor in the production 
of albinism ; there are, 
however, many instances 
of heredity in this ano- 
maly on record, and this 
idea is possibly in har- 
mony with the majority 
of observers. GeofFroy- 
Saiut-Hilaire has noted 
that albinism can also 
be the consequence of 
a pathologic condition 
having its origin in ad- 
verse surroundings, the 
circumstances of the jiarents, such as the want of exercise, nourishment, 
light, etc. 

Lesser knew a family in which six out of seven Avere albinos, and in some 
tropical countries, such as I^oango, Lower Guinea, it is said to be endemic. 
It is exceptional for the parents to be affected ; but in a case of Schlegel, 
quoted by Crocker, the grandfather was an albino, and Marey^ describes the 
case of the Cape May albinos, in wliich the mother and father were '' fair 
emblems of the African race," and of their children three Mere black and 
three were white, born in the following order : two consecutive black boys, 

a 1-24, 1839. 

Fig. 73. — An albino family. 


two consecutive white girls, one black girl, one white boy. Sym of Edin- 
burgh ^ relates the history of a family of seven children, who were alternately 
white and black. All but the seventh were living and in good health and 
mentally without defect. The parents and other relatives were dark. Figure 
73 portravs an albino family by the name of Cavalier who exhibited in 
Minneapolis in 1887. 

Examples of the total absence of pigment occur in all races, but particu- 
larlv is it interesting when seen in negroes wdio are found absolutely white 
but preserving all the characteristics of their race, as, for instance, the 
kinkv, woolly hair, flattened nose, thick lips, etc. Rene Caille, in his " A^oyage 
a Tombouctou," says that he saw a white infant, the offspring of a negro and 
negress. Its hair was white, its eyes blue, and its lashes flaxen. Its 
pupils w^ere of a reddish color, and its physiognomy that of a Mandingo. 
He says such cases are not at all uncommon ; they are really negro albinos. 
Thomas Jeiferson, in his " History of Virginia," has an excellent description 
of these negroes, with their tremulous and weak eyes ; he remarks that they 
freckle easily. Buffbn speaks of Ethiops with white twins, and says that 
albinos are quite common in Africa, being generally of delicate constitution, 
twinkling eyes, and of a low degree of intelligence ; they are despised and 
ill-treated by the other negroes. Prichard, (pioted by Sedgwick, speaks of a 
case of atavic transmission of albinism through the male line of the negro 
race. The grandfather and the grandchild were albinos, the father being 
black. There is a case ^' of a brother and sister who were albinos, the parents 
being of ordinary color but the grandfather an albino. Coinde, quoted by 
Sedgwick, speaks of a man who, by two different wives, had three albino 

A description of the ordinary type of albino would be as follows : The 
skin and hair are deprived of pigment ; the eyebrows and eyelashes are of a 
brilliant white or are yellowish ; the iris and the choroid are nearly or entirely 
deprived of coloring material, and in looking at the eye we see a roseate 
zone and the ordinary pink pupil ; from absence of pigment they neces- 
sarily keep their eyes three-quarters closed, being photophobic to a high 
degree. They are amblyopic, and this is due partially to a high degree of 
ametropia (caused by crushing of the eyeball in the endeavor to shut out 
light) and from retinal exhaustion and nystagmus. Many authors have 
claimed that they have little intelligence, but this opinion is not true. Ordi- 
narily the reproductive functions are normal, and if we exclude the results of 
the union of two albinos we may say that these individuals are fecund. 

Partial albinism is seen. The parts most often affected are the genitals, 
the hair, the face, the top of the trunlr, the nipple, the back of the hands 
and fingers. Folker*^' reports the history of a case of an albino girl having 
pink eyes and red hair, the rest of the family having pink eyes and white 

a 476, July 11, 1891. ^ 580, Aug., 1888. ^^ 476, 1876, i., 795. 


hair. Partial all)inisni, necessarily congenital, presenting a piebald appear- 
ance, must not be confounded with leukoderma, which is rarely seen in the 
young and which will be described later. 

Albinism is fomid in the lower animals, and is exemplified ordinarily 
by rats, mice, crows, robins, etc. In the Zoologic Garden at Baltimore two 
years ago was a pair of pure albino opossums. The white elephant is cele- 
brated in the religious history of Oriental nations, and is an object of venera- 
tion and worship in Siam. White monkeys and white roosters are also 
worshiped. In the Natural History ^Museum in London there are stuffed 
examples of albinism and melanism in the lower animals. 

Melanism is an anomaly, the exact contrary of the preceding. It is 
characterized by the presence in the tissues and skin of an excessive amount 
of pigment. True total melanism is unknown in man,' in whom is only 
observed partial melanism, characterized simply by a pronounced coloration 
of part of the integument. 

Some curious instances have been related ^ of an infant with a two-colored 
face, and of others with one side of the face white and the other l^lack ; 
whether they were cases of partial albinism or partial melanism cannot be 
ascertained from the descriptions. 

Such epidermic anomalies as ichthyosis, scleroderma, and molluscum sim- 
plex, sometimes appearing shortly after birth, but generally seen later in life, 
will be spoken of in the chapter on Anomalous Skin Diseases. 

Human horns are anomalous outgrowths from the skin and are far more 
frequent than ordinarily supposed. Nearly all the older writers cite exam- 
ples. Aldrovaudus, Amatus Lusitanus, Boerhaave, Dupre, Schenck, River- 
ius, Vallisneri, and many others mention horns on the head. In the ancient 
times horns were symbolic of wisdom and power. ^Michael Angelo in his 
famous sculpture of ]Moses has given the patriarch a ])air of horns. Rho- 
dius ^^^ observed a Benedictine monk who had a pair of horns and who was 
addicted to rumination. Fabricius ^'^ saw a man with horns on his head, 
whose son ruminated ; the son considered that by virtue of his ruminating 
characteristics his father had transmitted to him the peculiar anomaly of the 
family. Fabricius Hildanus *'^ saw a patient with horns all over the body 
and another with horns on the forehead. Gastaher '' speaks of a horn from 
the left temple ; Zacutus Lusitanus ^^^ saw a horn from the heel ; AYroe, ''-^ one 
of considerable length from the scapula ; Cosnard, one from the bregma ; the 
Fphemerides, from the foot ; Borellus, from the face and foot, and Ash,*^ horns 
all over the body. Home, Cooper, and Treves have collected examples of 
horns, and there is one 11 inches long and 2^ in circumference in a London 
museum. Lozes collected reports of 71 cases of horns, — 37 in females, 31 
in males, and three in infants. Of tliis number, 1 5 were on the head, eight on 
the face, 18 on the lower extremities, eight on the trunk, and three on the glans 

a 683, 1696, 254. ^ 418, 1776. c 629, 176. 


penis. Wilson ^ collected reports of 90 cases, — 44 females, 39 males, the sex 
not being mentioned in the remainder. Of these 48 were on the head, four 
on the lace, four on the nose, 11 on the thigh, three on the leg and foot, six 
on the back, five on the glans penis, and nine on the trunk. Lebert's ^^" col- 
lection numbered 109 cases of cutaneous horns. The greater frequency 
among females is admitted by all authors. Old age is a predisposing cause. 
Several patients over seventy have been seen and one of ninety-seven.*^ 

Instances of cutaneous horns, when seen and reported by the laity, give 
rise to most amusing exaggerations and descriptions. The following account ^ 
is given in New South AVales, obviously embellished with apocryphal details 
by some facetious journalist : The child, five weeks old, was born with hair 
two inches long all over the body ; his features were fiendish and his eyes 
shone like beads beneath his shaggy brows. He had a tail 18 inches 
long, horns from the skull, a full set of teeth, and claw-like hands ; he 
snapped like a dog and crawled on all fours, and refused the natural suste- 
nance of a normal child. The mother almost became an imbecile after the 
birth of the monster. The country peojilc about Bomballa considered this 
devil-child a punishment for a rel)utf that the mother gave to a Jewish 
peddler selling Crucifixion-pictures. Vexed by his persistence, she said she 
would sooner have a devil in her house than his picture. 

liamprey '^ has made a minute examination of the nuich-spoken-of 
" Horned Men of Africa." He found that this anomaly Avas caused by a 
congenital malformation and remarkable development of the infraorbital 
ridge of the maxillary bone (Fig. 74). He described several cases, and 
through an interpreter found that they Avere congenital, followed no history 
of traumatism, caused little inconvenience, and were unassociated with dis- 
turbance of the sense of smell. He also learned that the deformity was 
quite rare in the Cape Coast region, and received no information tending to 
prove the conjecture that the tribes in West Africa used artificial means to 
produce the anomaly, although such custom is prevalent among many 

Probably the most remarkable case of a horn was that of Paul Rodrigues, 
a Mexican porter,*^ who, from the upper and lateral part of his head, had a 
horn 14 inches in circumference and divided into three shafts, which he 
concealed by constantly wearing a peculiarly shaped red cap. There is in 
Paris a wax model of a horn, eight or nine inches in length, removed from 
an old woman by the celeV)rated Souberbielle. Figure 75 is from a wax model 
supposed to have been taken from life, showing an enormous grayish-black 
horn proceeding from the forehead. Warren mentions a case under the care 
of Dubois, in a woman from whose forehead grew a horn six inches in diam- 
eter and six inches in height. It was hard at the summit and had a fetid 

a 550, vol. xxvii., p. 60. b 418, 1776, i., 311. t- Quoted in 759, April, 1894. 

d224, 1887, ii., 1273. e New York Medical Repository, 1820. 



odor. In 1696 there was an old woman in France who constantly shed 
long horns from her forehead, one of which was presented to the King. 
Bartholimis mentions a horn 12 inches long. Voigte cites the case of an old 
woman who had a horn l)ranching into three portions, coming from her fore- 
head. Sands " s]>eaks of a woman who had a horn 6| inches long, growing 
from her head. There is an account*^ of the extirpation of a horn nearly 
ten inches in length from the forehead of a woman of eighty-two. Bejau *^ 
describes a woman of forty from whom he excised an excrescence resembling 
a ram's horn, growing from the left parietal region. It cnrved forward and 
nearly reached the corresponding tnl^erosity. It was eight cm. long, two cm. 
broad at the base, and 1| cm. at the apex, and was quite mobile. It began to 
grow at the age of eleven and had constantly increased. Vidal presented 

Fig. 74. — "African horned man " (Lamprey). 

Fig. 75.— Wax model of a large frontal horn. 

before the Academic de Medecine in 1886 a twisted horn from the head of 
a woman. This excrescence was ten inches long, and at the time of presenta- 
tion reproduction of it was taking place in the woman. Figure 76 shows 
a of ichthyosis cornea pictured in the Lancet, 1850.*^ 

There was a woman of seventy-five, living near York,*^ who had a horny 
growth from the face which she broke off and which l)egan to reproduce, 
the illustration (Fig. 77) representing the growth during, twelve months. 
Lain mentions a horn from the cheek ; Gregory reports one that measured 1^ 
inches long that was removed from the temple of a woman in Edinburgh ; 
Chariere of Barnstaple saw a horn that measured seven inches growing from 
the nape of a woman's neck ; Kameya Iwa s speaks of a dermal horn of the 

a 597, 1851. b 104^ I857, c 749^ 1886, 487. 

e 779, xvi., 267. f 435,1883. 

d476, 1850, ii., 342. 

g Tokei Iji Sliinshi, 1881. 



auricle ; Saxton of New York has excised several horns from the tympanic 
membrane of the ear ; Noyes ^ speaks of one from the eyelid ; Bigelow ^ 

Fig. 76. — Ichthyosis coruea. 

mentions one from the chin ; Minot ° speaks of a horn from the lower lip, 
and Doran'^ of one from the neck. 

Gould ® cites the instance of a horn growing from an epitheliomatous 
penis. The patient was fifty- 

two years of age and the 
victim of congenital phimosis. 
He was circumcised four years 
previously, and sliortly after 
the wound healed there ap- 
peared a small wart, followed 
by a horn about the size of a 
marble. Jewett speaks of a 
penile horn '?>\ inches long 
and 3 1 inches in diameter; 
Pick mentions one ^2\ inches 
long (Fig. 78). There is an 
account^ of a Russian peasant 
boy who had a horn on his 
penis from earliest childhood. 
Johnson ^ mentions a case of 
a horn from the scrotum, 
which was of sel^aceous origin 
and was subsequently sup- 
planted by an epithelioma. 
Ash reported the case of a girl 
named Annie Jackson, living in AVaterford, Ireland, who had horny excres- 

Fig. 78. — Horn of the jienis (atter Pick). 

a 538, 1869. 
e 476, 1887, i., 421. 

b 331, 1867, vol. xix. c 218, 1864. d 779^ I88I. 
f 224, Aug. 13, 1887. g 476, 1844. 



cences from her joints, arms, axillsie, nipples, ears, and forehead. Locke speaks 
of a bov at the Hopital de la Charite in Paris, who had horny excrescences four 
inches long and 1 J inches in circumference growing from his fingers and toes. 
Wagstaflfe ^ presents a horn which grew from the middle of the leg six 
inches below the knee in a Avoman of eighty. It was a flattened spiral of 
more than two turns, and during forty years' growth had reached the length 
of 14.3 inches. Its height was 3.8 inches, its skin-attachment 1.5 inches 
in diameter, and it ended in a blunt extremity of 0.5 inch in diameter. 
Stejihens ^ mentions a dermal horn on the buttocks at the seat of a carcino- 
matous cicatrix. Harris ° and Domonceau ^ speak of horns from the leg. 
Cruveilhier *^ saAva Mexican Indian who had a h')rn four inclics long and eight 
inches in circumference growing from the left lumbar region. It had been 
sawed oif twice by the patient's son and was finally extirpated by Faget. 
__ The length of the pieces was 

12 inches. Bellamy^ saw a 
horn on the clitoris about the 
size of a tiger's claw in a 
woman of seventy. It had 
its origin from beneath the 
preputium clitoridis. 

Horns are generally soli- 
tary, l)ut cases of multiple 
formation are known. Lewin 
and Heller record a syphilitic 
case with eight cutaneous 
horns on the palms and soles. 
A female patient of Manzu- 
roff had as many as 185 horns. 
Pancoast ^ reports the case of 
a man whose nose, cheeks, 
forehead, and lips were covered with horny growths, which had apparently 
undergone epitheliomatous degeneration. The patient was a sea-captain of 
seventy-eiglit, and had been exposed to the winds all his life. He had 
suffered three attacks of erysipelas from prolonged exposure. AVhen he 
consulted Pancoast the horns had nearly all fallen oif and were brought to 
the j)hysician for inspection ; and the photograph (Fig. 79) was taken after 
the patient had tied the horns in situ on his face. 

Anomalies of the Hair. — Congenital alopecia is quite rare, and it 
is seldom that we see instances of individuals who have been totally destitute 
of hair from birth. Danz '' knew of two adult sons of a Jewish fimilv wlio 


79. — Cutaneous horns. Showing beginning epitheliomatous 
degeneration of the base (after Pancoast). 

a 779, 1870. 
<i462, xiv., 145. 
5 631, 1878. 

b 435. 1872. 

^ Aiiat. patholog. du corps Imniain. 

c .527, 1842. 
f 779, 1870. 
li 160, 1792. 


never had hair or teeth. Sedgwick ^ quotes the case of a man of fifty-eight 
who ever since birth was totally devoid of hair and in whom sensible perspira- 
tion and tears were absent. A cousin on his mother's side, born a year before 
him, had precisely the same peculiarity. Buifon says that the Turks and 
some other people practised depilatory customs by the aid of ointments and 
pomades, principally about the genitals. Atkinson ^ exhibited in Philadel- 
phia a man of forty who never had any distinct growth of hair since birth, 
was edentulous, and destitute of the sense of smell and almost of that of 
taste. He had no apparent perspiration, and when working actively he was 
obliged to wet his clothes in order to moderate the heat of his body. He 
could sleep in wet clothes in a damp cellar without catching cold. There 
was some hair in the axillae and on the pubes, but only the slightest down on 
the scalp, and even that was absent on the skin. His maternal grandmother 
and uncle were similarly affected ; he was the youngest of 21 children, had 
never been sick, and though not able to chew food in the ordinary manner, 
he had never suffered from dyspepsia in any form. He Avas married and had 
eight children. Of these, two girls lacked a number of teeth, but had the 
ordinary quantity of hair. Hill '^ speaks of an aboriginal man in Queensland 
who was entirely devoid of hair on the head, face, and every part of the 
body. He had a sister, since dead, who was similarly hairless. Hill men- 
tions the accounts given of another black tribe, about 500 miles west of 
Brisbane, that contained hairless members. This is very strange, as the 
Australian aboriginals are a very hairy race of people. 

Hutchinson '^ mentions a boy of three and a half in whom there was con- 
genital absence of hair and an atrophic condition of the skin and appendages. 
His mother was bald from the age of six, after alopecia areata. Schede re- 
ports two cases of congenitally bald children of a peasant woman (a boy of 
thirteen and a girl of six months). They had both been born quite bald, and 
had remained so. In addition there were neither eyebrows nor eyelashes and 
nowhere a trace of lanugo. The children were otherwise healthy and well 
formed. The parents and brothers were healthy and possessed a full growth 
of hair. Thurman ® reports a case of a man of fifty-eight, who was almost 
devoid of hair all his life and possessed only four teeth. His skin was very 
delicate and there was absence of sensible perspiration and tears. The skin 
was peculiar in thinness, softness, and absence of pigmentation. The hair on 
the crown of the head and back was very fine, short, and soft, and not more 
in quantity than that of an infant of three months. There was a similar pecu- 
liarity in his cousin-germ an. AVilliams mentions the case of a young lady 
of fifteen with scarcely any hair on the eyebrows or head and no eyelashes. 
She was edentulous and had never sensibly perspired. She improved under 
tonic treatment. 

a 222, 1863, i., 453. b 218, March 29, 1883. c 224, 1881. i., 177. 

d650, 1885-6, ii., 116. e 550, xxxi., 71. 


Raver quotes the case of Beaiivais, who was a patient in the Hopital de la 
Charite in 1827. The skin oftliis man's cranium was apparently completely 
naked, although in examining it narrowly it was found to be beset with a 
quantity of very white and silky hair, similar to the down that covers the scalp 
of infants ; here and there on the temples there were a few black specks, occa- 
sioned by the stumps of several hairs which the patient had shaved off. The 
eyebrows were merely indicated by a few fine and very short hairs ; the free 
edges of the eyelids were witliout cilia, but the bulb of each of these was indi- 
cated by a small, whitish point. The beard was so thin and weak that-Beauvais 
clipped it off only every three weeks. A few straggling hairs were observed on 
the breast and pubic region, as in young people on the approach of puberty. 
There was scarcely any under the axillae. It was rather more abundant on 
the inner parts of the legs. The voice was like that of a full-grown and well- 
constituted man. Beauvais was of an auK^rous disposition and had had syph- 
ilis twice. His mother and both sisters had good heads of hair, but his father 
presented the same defects as Beauvais. 

Instances are on record of women devoid of hair about the genital region. 
Riolan says that he examined the body of a female libertine who was totally 
hairless from tlie umbilical region down. 

Congenital alopecia is seen in animals. There is a species of dog, a 
native of- China but now bred in Mexico and in the United States, which 
is distinguished for its congenital alopecia. The same fact has been observed 
occasionally in horses, cattle, and dogs. Heusner * has seen a pigeon desti- 
tute of feathers, and which engendered a female which in her turn transmitted 
the same characteristic to two of her young. 

Sexualism and Hair Growth. — The growth or development of the hair 
may be accelerated l)y the state of the organs of generation. This is pecidiarly 
noticeable in the pubic hairs and the beard, and is fully exemplified in the sec- 
tion on precocious development (Chapter YII.) ; however, Moreau de la Sarthe 
showed a child to the ]\Iedical Faculty of Paris in whom precocious develop- 
ment of the testicles had influenced that of the hair to such a degree that, 
at the age of six, the chest of this boy was as thickly set with hair as is 
usually seen in adults. It is well known that eunuchs often lose a great 
part of their beards, and after removal of the ovaries women are seen to 
develop an extra quantity of hair. Gerberon ^^ tells of an infant with a 
beard, and Paullini ^ and the Ephemerides mention similar instances. 

Bearded women are not at all infrequent. Hippocrates mentions a 
female who grew a beard shortly after menstruation had ceased. It is 
a well-recognized fact that after the menopause women become more 
hirsute, the same being the case after removal of any of the functional 
generative apparatus. Vicat saw a virgin who had a beard, and Joch*^ 

a 390, 153. >J 215, aun.,ii. 

c 620, cent, iii., obs. 64. d Dissert., etc., Jenae. 



speaks of " foeminis barbati." Leblond "" says that certain women of 
Ethiopia and South America have beards and little or no menstruation. He 
also says that sterility and exces- 
sive chastity are causes of female 
beards, and cites the case of 
Schott of a young widow who 
secluded herself in a cloister 
and soon had a beard. 

Barbara Urster, who lived in 
the 1 6th century, had a beard to 
her girdle. The most celebrated 
" bearded woman " was Rosine- 
Marguerite Muller, Avho died in 
a hospital in Dresden in 1732, 
with a thick beard and heavy 
mustache. Julia Pastrana had 
her face covered with thick hair 
and had a full beard and mus- 
tache. She exhibited defective 
dentition in both jaws, and the 
teeth present were arranged in 

an irregular fashion. She had pronounced prognathism, which gave her a 
simian appearance (Fig. 80), Ecker examined in 1876 a woman who died 
at Fribourg, whose face contained a full beard and a luxuriant mustache. 

Julia Pastrana. 

Fig. 81. 

Bearded insane women (Harris). 

Harris '' reports several cases of bearded women, inmates of the Coton Hill 

Lunatic Asylum. One of the patients was eighty-three years of age and had 

a 302, iii., 9. b 224, Juue 2, 1894. 

/ - 



been insane forty-four years following a puerperal period. She would not 
permit the hair on her face to be cut, and the curly white hairs had attained 
a length of from eight to ten inches on the chin, while on the U])per lip the 
hairs were scarcely an inch. This patient was quite womanly in all her senti- 
ments (Fig. 81). The second case was a woman of thirty-six, insane from 
emotional melancholia. She had tufts of thick, curly hair on the chin two 
inches long, light yellowish in color, and a few straggling hairs on the upper 
lip. The third case (Fig. 82) was that of a woman of sixty-four, wlio 
exhibited a strong passion for the male sex. Her menstruation had l^een 
regular until the menopause. She plaited her beard, and it was seven or 

eight inches long on the chin and 
one inch on the lip. This woman 
had extremely hairy legs. Another 
case was that of a woman of sixty- 
two, who, though l)ald, developed 
a beard before the climacteric. 
Her structural proportions were 
feminine in character, and it is said 
that her mother, who Mas sane, 
had a beard also. A curious case 
was that of a woman of twenty- 
three (Mrs. Viola M.), who from 
the age of three had a considerable 
quantity of hair on the side of the 
check which eventually became a 
full beard. She was quite feminine 
and was free from excessive hair 
elsewhere, her nose and forehead 
l)eing singularly bare. Her voice 
was very sweet ; she was married 
at seventeen and a half, having 
two normal children, and nursed 
each for one month. " The bearded 
woman " of every circus side-show is an evidence of the curious interest in 
w'hicli these women are held. The accompanying illustration (Fig. 83) is 
a representation of a '' bearded woman " born in Bracken County, Ky. Her 
beard measured 15 inches in length. 

There is a class of anomalies in which there is an exaggerated develop- 
ment of hair. AVe would naturally expect to find the primitive peoples, who 
are not provided with artificial protection against the wind, supplied with an 
extra quantity of hair or having a hairy coat like animals ; but this is some- 
times found among civilized people. This abnormal presence of hair on the 
human body has been known for many years ; the description of Esau in the 

'Bearded woman." 



Bible is an early instance. Aldrovandus says that in the sixteenth century 
there came to the Canary Islands a family consisting of a father, son, and 
two daughters, who were covered all over their bodies by long hair, and their 
portrait, certainly reproduced from life, resembles the modern instances of 
" dog men." 

In 1883 there was shown in England and France, afterward in America, 
a girl of seven named " Krao," a native of Indo-China. The whole body 
of this child was covered with black hair. Her face was of the prognathic 
type, and this, with her extraordinary prehensile powers of feet and lips, gave 
her the title of " Darwin's missing link." In 1875 there was exhibited in 
Paris, under the name of " I'homme-chien " Adrien Jeftichew, a Russian 

Fig. 84. — Two examples of extreme hirsuties in a family. 

peasant of fifty-five, whose face, head, back, and limbs were covered with a 
brown hairy coat looking like wool and several centimeters long. The other 
parts of the body were also covered with hair, but less abundantly. This 
individual had a son of three, Theodore, who was hairy like himself 

A* family living in Burmah (Shive-Maon, whose history is told by Craw- 
ford and Yule), consisting of a father, a daughter, and a granddaughter, were 
nearly covered with hair. Figure 84 represents a somewhat similar family 
who were exhibited in this country. 

Teresa Gambardella, a young girl of twelve, mentioned by Lombroso, was 
covered all over the body, with the exception of the hands and feet, by thick, 
bushy hair. This hypertrichosis was exemplified in this country only a few 
months since by a person who went the rounds of the dime museums under 



the euphonious name of " Jo-Jo, the dog-face boy." His face Avas truly that 
of a skye-terrier (Fig-. 85). 

Sometimes the hairy anomahes are but instances of naevus pilosus. The 
Inchan ourang-outang woman examined at the office of the Lancet was an 
cxamj)le of this kind. Hebra, Hiklebrandt, Jabk)koif, and Klein describe 
similar cases. Many of the older " wild men " were individuals bearing 
extensive hairy moles. 

Rayer remarks that lie lias seen a young man of sixteen mIio exhibited 
himself to the public under the name of a new species of wild man whose 
breast and l)ack were covered with light brown hair of considerable length. 

Fig. So.— '•.T.,-,l< 

Fig. 86. — " Wdiiian with a mane" (dkvus pilosus). 

The surfiice upon which it grew was of a brownish hue, different from the 
color of the surroundino; intey^ument. Almost the whole of the right arm was 
covered in the same manner. On the lower extremity several tufts of hair 
were observed implanted upon brown spots from seven to eight Unes in diameter 
symmetrically disposed upon both legs. The hair was brown, of the same 
€olor as that of the head. Bichat^ informs us that he saw at Paris an un- 
fortunate man who from his birth was afflicted with a luiiry covering of his 
face like tliat of a wild Ijoar, and he adds that the stories Avhich were current 
among the vulgar of individuals with a boar's head, wolf's head, etc., un- 
a Anat. Generale, Pan.s, 1812, T. iv., 827. 



-doubtedly referred to cases in which the face was covered to a greater or less 
degree with hair. Villerme saw a child of six at Poitiers in 1808 whose 
body, except the feet and hands, was covered with a great nnniber of promi- 
nent brown spots of different dimensions, beset with hair shorter and not so 
strong as that of a boar, but bearing a certain resemblance to the bristles of 
that animal. These spots occupied about one-fifth of the surface of this 
child's skin. Campaignac in the early part of this century exhibited a case 
in which there was a large tuft of long black hair growing from the shoulder. 
Dufour^^ has detailed a case of a young man of twenty whose sacral region 
contained a tuft of hair as long and black, thick and pliant, as that of the 
head, and, particularly remarkable in this case, the skin 
from which it grew was as fine and white as the integument 
of the rest of the body. There was a woman exhibited 
recently, under the advertisement of" the lady with a mane," 
who had growing from the center of her back between the 
shoulders a veritable mane of long, black hair, which 
doubtless proceeded from a form of nsevus (Fig. 8(3). 

Duyse ^ reports a case of extensive hypertrichosis of the 
back in a girl aged nine years ; her teeth were normal ; there 
was pigmentation of the back and numerous pigmentary nevi 
on the face. Below each scapula there were tumors of the 
nature of fibroma molluscum. In addition to hairy nevi 
on the other parts of the body there was localized ichthyosis. 

Ziemssen figures an interesting case of nsevus pilosus 
resembling " bathing tights " (Fig. 87). There were also 
present several benign tumors (fibroma molluscum) and 
numerous smaller nevi over the body. Sehulz first observed 
the patient in 1878. This individual's name was Blake, 
and he stated that he was born with a large nsevus spread- 
ing over the upper parts of the thighs and lower parts of the 
trunk, like bathing-tights, and resembling the pelt of an 
animal. The same was true of the small hairy j)arts and 
the larger and smaller tumors. Subsequently the altered portions of the skin 
had gradually become somewhat larger. The skin of the large hairy nsevus, 
as well as that of the smaller ones, was stated by Sehulz to have been in the 
main thickened, in part uneven, verrucose, from very light to intensely dark 
brown in color ; the consistency of the larger mammiform and smaller tumors 
soft, doughy, and elastic. The case was really one of large congenital nsevus 
pilosus and fibroma molluscum combined. 

A Peruvian boy was sho\\n at the Westminster Aquarium with a dark, 
hairy mole situated in the lower part of the trunk and on the thighs in the 
position of bathing tights. Nevins Hyde records two similar cases with 

a 162, T. xxvi., 274. b La Flandre Med., Oct. 4, 1894. 

Fig. 87. — Large nse- 
vus pilosus resembling 
" bathing-tights." 



dermatolytic growths.* A sister of the Peruvian boy referred to had a still 
larger growth, extending from the nucha all over the back. Both she and 
her brother had hundreds of smaller hairy growths of all sizes scattered 
irregularly over the face, ti-unk, and limbs. According to Crocker, a still 
more extraordinary case, with extensive dermatolytic growths all over the 
back and nevi of all sizes elsewhere, is described and engraved in " Lavater's 
Physiognomy," 1848. Baker'' describes an operation in wliich a large mole 
occupying half the forehead was removed by the knife. 

In some instances the hair and beard is of an enormous length. 

Erasmus Wilson of Lon- 
don saw a female of thirty- 
eight, M'hose hair measured 
1.65 meters long. Leonard 
of Philadelphia speaks of a 
man in the interior of this 
country whose beard trailed 
on the ground wlien he stood 
upright, and measured 2.24 
meters long:. Not long: as:o 
there appeared the famous 
so-called " Seven Suther- 
land Sisters," whose hair 
touched the ground, and 
witii whom nearly every one 
is familiar through a hair 
tonic which they extensive- 
ly advertised. In Nature, 
Januaiy 9, 1892, is an ac- 
count of a Percheron horse 
whose mane measured 13 
feet and whose tail meas- 
ured almost ten feet, prob- 
ably the greatest example of 
excessive mane development 
on record. Figure 88 represents Miss Owens, an exhibitionist, whose hair 
measured eight feet three inches. In Leslie's Weekly, January 2, 1896, there 
is a portrait of an old negress named Nancy Garrison whose. woolly hair was 
equally as long. 

The Ephemerides ^ contains the account of a woman who had hair from 
the mons veneris which hung to the knees ; it was affected with plica polo- 
nica, as was also the other hair of the body. 

Payer saw a Piedmontese of twenty-eight, with an athletic build, who had 
a 445, iii., 93. b 550, Ixi. c 104, dec. 2, an. vi., 1688. 

Fig. 88. — Example of excessive growth of hair. 


but little beard or hair on the trunk, but whose scalp was covered with a 
most extraordinary crop. It was extremely fine and silky, was artificially 
frizzled, dark brown in color, and formed a mass nearly five feet in circum- 

Certain pathologic conditions may give rise to accidental growths of 
hair. Bover was accustomed to quote in his lectures the case of a man who, 
having an inflamed tumor in the thigh, perceived this part becoming covered 
in a short time with numerous long hairs. Kayer speaks of several instances 
of this kind. In one the part affected by a blister in a child of two became 
covered with hair. Another instance was that of a student of medicine, who 
after bathing in the sea for a length of time, and exposing himself to the hot 
sun, became affected with coppery patches, from which there sprang a growth 
of hair. Bricheteau, quoted by the same authority, speaks of a woman of 
twenty-four, having white skin and hair of deep black, who after a long ill- 
ness occasioned by an affection analogous to marasmus became covered, 
especially on the back, breast, and abdomen, with a multitude of small eleva- 
tions similar to those which appear on exposure to cold. These little 
elevations became brownish at the end of a few days, and short, fair, silky 
hair was observed oil the summit of each, which grew so rapidly that the 
whole surface of the body with the exception of the hands and face became 
velvetv. The hair thus evolved was afterward thrown out spontaneously and 
was not afterward reproduced. 

Anomalies of the Color of the Hair. — Xew-born infants sometimes 
have tufts of hair on their heads which are perfectly white in color. Schenck 
speaks of a young man whose beard from its first appearance grew white. 
Young men from eighteen to twenty occasionally become gray ; and accord- 
ing to Rayer, paroxysms of rage, unexpected and unwelcome news, diseases 
of the scalp such as favus, wounds of the head, habitual headache, over- 
indulgence of the sexual appetite, mercurial courses too frequently repeated, 
too great anxiety, etc., have been known to blanch the hair prematurely. 

The well-accepted fact of the sudden changing of the color of the 
hair from violent emotions or other causes has always excited great interest, 
and many ingenious explanations have been devised to account for it. There ^ 
is a record in the time of Charles V. of a young man who was committed 
to prison in 1546 for seducing his girl companion, and Avhile there was in 
great fear and grief, expecting a death-sentence from the Emperor the next day. 
When brought before his judge, his face was wan and pale and his hair and 
beard gray, the change having taken place in the night. His beard was filthy 
with drivel, and the Emperor, moved by his pitiful condition, pardoned him. 
There was a clerg^•man ^ of Xottingham whose daughter at the age of 
thirteen experienced a change from jet-blackness of the hair to white in a 
single night, but this was confined to a spot on the back of the head 1|- 

a 564, iii., 515. 


inclies in length. Her liair soon became striped, and in seven years was 
totally white. The same article speaks of a girl in Bedfordshire, ]Maria 
Seeley, aged eight, whose face was swarthy, and whose hair was long and 
dark on one side and light and short on the other. One side of her body 
was also brown, while the other side was light and fair. She was seen by 
the faculty in London, but no cause could be established. 

Voigtel mentions the occurrence of canities almost suddenly. Bichat had 
a personal acquaintance whose hair became almost entirely gray in conse- 
quence of some distressing news that reached him. Cassan ^ records a 
similar case. According to Rayer, a woman by the name of Perat, sum- 
moned before the Chamber of Peers to give evidence in the trial of the 
assassin Louvel, was so much aifected that her hair became entirely wdiite in 
a single night. Byron makes mention of this peculiar anomaly in the open- 
ing stanzas of the " Prisoner of Chillon : " — 

' ' My hair is gray, but not with years, 
Nor grew it white 
In a single night, 
As men's have grown from sudden fears." 

The commentators say that Byron had reference to Ludovico Sforza and 
others. The fact of the change is asserted of Marie Antoinette, the wife of 
Louis XVL, though in not quite so short a period, grief and not fear being the 
cause. Ziemssen cites Landois' case of a compositor of thirty-four who was 
admitted to a hospital July 9th with symptoms of delirium tremens ; until 
improvement began to set in (July 13th) he was continually tormented by 
terrifying pictures of the imagination. In the night preceding the day last 
mentioned the hair of the head and beard of the patient, formerly blond, 
became gray. Accurate examination by Landois showed the pigment con- 
tents of the liair to be unchanged, and led him to believe that the white color 
was solely due to the excessive development of air-bubbles in the hair shaft. 
Popular belief brings the premature and especially the sudden whitening 
into connection with depressing mental emotions. We might quote the 
German expression — " Sich graue Haare etwas wachsen lassen " (" To worry 
one's self gray "). Brown-Sequard observed on several occasions in his 
own dark beard hairs whieli had turned white in a night and which he 
epilated. He closes his brief communication on the subject with the belief 
that it is quite possible for black hair to turn white in one night or even in a 
less time, although Hebra and Kaposi discredit sudden canities (Duhring). 
Raymond and Vulpian ^ observed a lady of neurotic type whose hair during 
a severe paroxysm of neuralgia f )ll()wing a mental strain changed color in 
five hours over the entire scalp except on the back and sides ; most of the 
hair changed from black to red, but some to quite white, and in two days 

a 162, Jan., 1827. b 476, Oct. 14, 1882. 


all the red hair became white and a quantity fell olf. The patient recovered 
her general health, Init with almost total loss of hair, only a few red, white, • 
and black hairs remaining on the occipital and temporal regions. Crocker 
cites the case of a Spanish cock which was nearly killed by some pigs. The 
morning after the adventure the feathers of the head had become completely 
white, and about half of those on the back of the neck were also changed. 

Dewees^ reports a case of puerperal convulsions in a patient under his 
care which was attended with sudden canities. From 10 a. m. to 4 p. m. 
50 ounces of blood were taken. Between the time of Dr. Dewees' visits, 
not more than an hour, the hair anterior to the coronal suture turned white. 
The next day it was less light, and in four or five days was nearly its natural 
color. He also mentions two cases of sudden blanching from fright. 

Fowler'' mentions the case of a healthy girl of sixteen who found one 
morning while combing her hair, which was black, that a strip the whole 
length of the back hair was white, starting from a surface about two inches 
square around the (X'ci})ital ])rotuberance. Two Aveeks later she had patches 
of ephelis over the whole Ijody. 

Prentiss, in Science, October .3, 1890, has collected numerous instances of 
sudden canities, several of which will be given : — 

"In the Canada Journal of Medical Science, 18(S2, p. 113, is reported a |/ 
case of sudden canities due to business-worry. The microscope showed a 
great many air-vesicles botli in the medullary substance and between the 
medullary and cortical substance. 

"In the Boston ^ledical and Surgical Journal, iSol, is reported a case of 
a man thirty years old, whose hair ' was scared ' white in a day by a grizzly 
bear. He was sick in a mining camp, was left alone, and fell asleep. On 
waking he found a grizzly bear standing over him. 

" A second case is that of a man of twenty-three years who was gambling 
in California. He placed his entire savings of $1100 on the turn of a card. 
He was under tremendous nervous excitement while the cards were being 
dealt. The next day his hair was perfectly white. 

" In the same ai'ticle is the statement that the jet-black hair of the Pacific 
Islanders does not turn gray gradually, but when it does turn it is sudden, 
usually the result of fright or sudden emotions." 

D'Alben, quoted by Fournier,*^ describes a young man of twenty-four, an 
officer in the regiment of Touraine in 1781, who spent the night in carnal 
dissipation with a mulatto, after which he had violent spasms, rendering flex- 
ion of the body impossible. His beard and hair on the right side of the body 
was found as white as snow, the left side being unchanged. He appeared be- 
fore the Faculte de ISIontpelier, and though cured of hig nervous symptoms 
his hair was still white, and no suggestion of relief was offered liim. 

Louis of Bavaria, who died in 1294, on learning of the innocence of his 

a Phila. Med. Museum, iii., 219. b 476, 1853, i., 556. c 302, iv., 176. 


wife, whom he had put to death on a suspicion of her infidelity, had a change 
of color in his hair, which became white almost immediately. Vauvilliers, 
the celebrated Hellenist, became white-haired almost immediately after a terri- 
ble dream, and Brizard, the comedian, experienced the same change after a 
narrow escape from drowning in the Rhone. The beard and the hair of the 
Duke of Brunswick whitened in twenty-four hours after hearing that his 
father had been mortally wounded at the battle of Auerstadt. 

De Schweinitz '^ speaks of a well-formed and healthy branette of eighteen 
in whom the middle portion of the cilia of the riglit upper eyelid and a number 
of the hairs of the lower lid turned white in a Aveek. Both eyes were myopic, 
but no other cause could be assigned. Another similar case is cited by Hirsh- 
berg, '' and the authors have seen similar cases. Thornton of Margate records 
the case of a lady in whom the hair of the left eyebrow and eyelashes began 
to turn white after a fortnight of sudden grief^ and within a week all the hair 
of these regions was quite white and remained so. Xo other part was 
aifected nor was there any other symptom. After a traumatic ophthalmitis 
of the left and sympathetic inflammation of the right eye in a boy of nine, 
Schenck observed that a group of cilia of the right upper lid and nearly all 
the lashes of the upper lid of the left eye, which had been enucleated, turned 
silvery-white in a short time. Ludwig has known the eyelashes to become 
white after small-pox. Communications are also on record of local decolor- 
ization of the eyebrows and lashes in neuralgias of isolated branches of the 
trigeminus, especially of the supraorl^ital nerve. 

Temporary and Partial Canities. — Of special interest are those cases in 
which whiteness of the hair is only temporary. Thus, Compagne mentions a 
case in which the black hair of a Avoman of thirty-six began to fade on the 
twenty-third day of a malignant fever, and on the sixth clay following was 
perfectly white, but on the seventh day the hairs became darker again, and on 
the fourteenth day after the change they had become as black as they were 
originally. Wilson records a case in which the hair lost its color in winter 
and regained it in summer. Sir John F()rl)es, according to Crocker, had gray 
hair for a long time, then suddenly it all turned white, and after remaining so 
for a year it returned to its original gray. 

Grayness of the hair is sometimes only partial. According to Crocker an 
adult whose hair was generally brown had a tuft of white hair over the tem- 
ple, and several like cases are on record. Lorry tells us that grayness of one 
side only is sometimes occasioned by severe headache. Hagedorn has known 
the beard to be black in one place and white in another. Brandis mentions the 
hair becoming white on one side of the face while it continued of its former 
color on the other, llayer quotes cases of canities of the whole of one side 
of the l)ody. 

Richelot observed white mottling of hair in a girl sick witli chlorosis. 

a 792, May, 1889. b 262, 1888. 



The whitening extended from the roots to a distance of two inches. The prob- 
able cause was a temporary aUeration of the pigment- forming- function. When 
the chlorosis was cured the natural color returned. Paullini and liiedlin, as 
well as the Ephemerides, speak of different colored hair in the same head, and 
it is not at all rare to see individuals with an anomalously colored patch of 
hair on the head. The members of the ancient house of Rohan were said to 
possess a tuft of white hair on the front of their heads. 

Michelson of Konigsberg describes a curious case in a barrister of twenty- 
three affected with partial canities. In the family of both parents there was 
stated to be congenital premature canities, and some white hairs had been 
observed even in childhood. In the fifteenth year, after a grave attack of 
scarlet fever, the hair to a great extent fell out. The succeeding growth of hair 
was stated to have been throughout lighter in tissue and color and fissured 
at the points. Soon after bunches of 
white hair appeared on the occiput, and 
in the succeeding years small patches 
of decolored hairs were observed also 
on the anterior and lateral portions of 
the scalp. In the spring of 1880 the 
patient exhibited signs of infiltration of 
the a])ex of the right lung, and afterward 
a violent headache came on. At the time 
of the report the patient presented the ap- 
pearance shown in Figure 89. The com- 
plexion was delicate throughout, the eye- 
lashes and eyelids dark l)rown, th(> mous- 
tache and whiskers blond, and in the 
latter were a few groups of white liair. 
The white patches were chiefly on the left 
side of the head. The hairs growing on 
them were unpigmented, but otherwise normal. The patient stated that his 
head never sweated. He was stout and exhibited no signs of internal disease, 
except at the apex of the right lung. 

Anomalous Color Changes of the Hair. — The hair is liable to undergo 
certain changes of color connected with some modification of that part of the 
bulb secreting its coloring-matter. Alibert, quoted by Rayer, gives us a 
report of the case of a young lady who, after a severe fever which followed a 
very difficult labor, lost a fine head of hair during a discharge of viscid fluid, 
which inundated the head in every part. He tells us, further, that the hair 
grew again of a deep black color after the recovery of the ])atient. The same 
writer tells of the case of James B — , born with brown hair, who, having lost 
it all during the course of a sickness, had it replaced with a crop of the 
brightest red. AVhite and gray hair has also, under peculiar circumstances, 

rig. 89.— Mottled hair (Michelson) 


been replaced by hair of the same color as the individual had in youth. We 
are even assured by Bruley that in 1798 the white hair of a woman sixty 
years of age changed to black a few days before her death. The bulbs in 
this case were found of great size, and appeared gorged with a substance from 
which the hair derived its color. The white hairs that remained, on the con- 
trary, grew from shriveled bulbs much smaller than those producing the 
black. This patient died of phthisis." 

A very singular case, published early in the century, was that of a woman 
whose hair, naturally fair, assumed a tawny red color as often as she was 
affected with a certain fever, and returned to its natural hue as soon as the 
symptoms abated.'^ Villerme •''^- alludes to the case of a young lady, sixteen 
years of age, who had never suffered except from trifling headaches, and who, 
in the winter of 1817, perceived that the hair began to fall out from several 
parts of her head, so that before six months were over she became entirely 
bald. In the beginning of January, 1819, her head became covered with a 
kind of black wool over those places that were first denuded, and light brown 
hair began to develop from the rest of the scalp. Some of this fell out again 
when it had grown from three to four inches ; the rest changed color at 
different distances from its end and grew of a chestnut color from the roots. 
The hair, half black, half chestnut, had a very singular appearance. 

Alibert and Beigel relate cases of women with blond hair which all came 
off after a severe fever (typhus in one case), and when it grew again it was 
quite black. Alibert also saw a young man wdio lost his brown hair after an 
illness, and after restoration it became red. According to Crocker, in an 
idiotic girl of epileptic type (in an asylum at Edinburgh), with alternating 
phases of stupidity and excitement, the hair in the stupid phase was blond 
and in the excited condition red. The change of color took place in the 
course of two or three days, beginning first at the free ends, and remaining 
of the same tint for seven or eight days. The pale hairs had more air-spaces 
than the darker ones. There was much structural change in the brain and 
spinal cord. Smyly of Dublin reported a case of suppurative disease of the 
temporal bone, in which the hair changed from a mouse-color to a reddish- 
brown ; and Squire records a congenital case in a deaf mute, in whom the hair 
on the left side was in light patches of true auburn and dark patches of dark 
brown like a tortoise-shell cap ; on the other side the hair was a dark brown. 
Crocker mentions the changes which have occurred in rare instances after 
death from dark l)rown to red. 

Chemic colorations of various tints occur. Blue hair is seen in workers 
in cobalt mines and indigo works ; green hair in copper smelters ; deep red- 
brown hair in handlers of crude anilin ; and the hair is dyed a purplish- 
brown whenever chrvsarobin applications used on a scalp come in contact 
with an alkali, as when washed with soap. Among such cases in older 

a 458, T. iv., 290. ^ 454, T. v., 59. 



literature Blanchard and Mareellus Donatus speak of green hair ; Rosse 
saw two instances of the same, for one of which he could find no cause ; tlie 
other patient worked in a brass foundrj. 

Many curious causes are given for alopecia. Gilil)ert and Merlet "^ 
mention sexual excess ; Mareellus Donatus '' gives fear ; the Ephemerides 
speaks of baldness from fright ; and Leo Africanus, in his description of 
Barbarv, describes endemic l)aldness. Xeyronis ^ makes the following ob- 
servation : A man of seventy-three, convalescent from a fever, one morning, 
about six months after recovery perceived that he had lost all his hair, even 
his eyelashes, eyebrows, nostril-hairs, etc. Although his health continued 
good, the hair was never renewed. 

The principal anomalies of the nails observed are absence, hyper- 
trophy, and displacement of these organs. Some persons are born with 
finger-nails and toe-nails either very rudimentary or entirely absent ; in 
others they are of great length and thickness. The Chinese nobility allow 
their finger-nails to grow to a 
great length and spend much 
time in the care of these nails. 
Some savage tribes have long 
and thick nails resembling the 
claws of beasts, and use them in 
the same way as the lower ani- 
mals. There is a description of 
a person with finger-nails that 
resembled the horns of a goat. ^ 
Neuhof, in his l)ooks on Tartary 
and China, says that many Chinamen have two nails on the little toe, and 
other instances of double nails have been reported. 

The nails may be reversed or arise from anomalous positions. Bartho- 
linus "" speaks of nails from the inner side of the digits ; in another case, in 
which the fingers were wanting, he found the nails im])lanted on the stumps. 
Tulpius says he knew of a case in which nails came from the articulations of 
three digits ; and many other curious arrangements of nails are to be found. 

Rouhuot sent a description and drawing of some monstrous nails to the 
Academic des Sciences de Paris (Fig. 90). The largest of these was the left 
great toe-nail, which, from its extremity to its root, measured 4| inches ; the 
laminae of which it consisted were placed one over the other, like the tiles on a 
roof, only reversed. This nail and several of the others were of unequal 
thickness and were variously curved, probably on account of the pressure 
of the shoe or the neighboring digits. Bayer mentions two nails sent tO' 
him by Bricheteau, physician of the Hopital Necker, belonging to an oldl 

" Diss, calvites, Paris, 1662. b 306, L. i., cap. i., p. 15. 

c 463, v., 73. d 282, Nov., 1734, 173. e 190, cent, ii., hist. 44. 


I)elorineil toe-nails. 


woman who had lived in the Salpetriere. Tliev Avere very thick and spirally 
twisted, like the horns of a ram. Saviard informs us that he saw a patient 
at the Hotel Dieu who had a horn like that of a ram, instead of a nail, on 
each great toe, the extremities of which were turned to the metatarsus and 
overlapped the whole of the t)ther toes of each foot. The skeleton of Si more, 
preserved in Paris, is remarkable for the ankylosis of all the articulations 
and the considerable size of all the nails. The lingers and toes, spread out 
and ankylosed, ended in nails of great length and nearly of equal thickness. 
A woman by the name of Melin, living in the last century in Paris, was 
surnamed " the woman with nails ; " according to the description given by 
Saillant in 177(3 she presented another and no*^ less curious instance of the 
excessive growth of the nails. 

Musaeus ^ gives an account of the nails of a girl of twenty, which grew to 
such a size that some of those of the fingers were five inches in length. They 
were composed of several layers, whitish interiorly, reddish-gray on the ex- 
terior, and full of black points. These nails fell off at the end of four months 
and were succeeded by others. There were also horny laminae on the 
knees and shoulders and elbows which l)ore a resemblance to nails, or rather 
talons. They were sensitive only at the point of insertion into the skin. 
Various other parts of the body, particularly the backs of the hands, pre- 
sented these horny productions. One of them was four inches in length. This 
horny growth appeared after small-pox. Ash, in the Philos()])hical Trans- 
actions, records a somewhat similar case in a girl of twelve. 

Anomalies of the Teeth. — Pliny, Colombus, van Swieten, Haller, Mar- 
cellus Donatus, Baudelocque, Soemmering, and Gardien all cite instances in 
which children have come into the world with several teeth already erupted. 
Haller '^'^'^ has collected 19 cases of children born with teeth. Polydorus 
Virgilus describes an infant who was born with six teeth. Some celebrated 
men are supposed to have been born with teeth ; Louis XIV. was accredited 
with having two teeth at birth. Bigot, a physician and philosopher of the six- 
teenth century ; Boyd, the poet; Valerian, Richard III., as well as some of 
the ancient Greeks and Romans, were reputed to have had this anomaly. 
The significance of the natal eruption of teeth is not always that of vigor, as 
many of the subjects succumb early in life. There were two cases typical of 
fetal dentition shown before the Academic de Medecine de Paris. One of the 
subjects had two middle incisors in the lower jaw and the other had one tooth 
well through. Levison '^ saw a female born with two centnd incisors in the 
lower jaw. 

Thomas '^ mentions a case of antenatal development of nine teeth. Puech, 
]\Iattei, Dumas, Belluzi, and others report the eruption of teeth in the new- 
born. In Dumas' case the teeth had to lie extracted on account of ulceration 
of the tongue. 

a Diss, de unguibus nionstrosis, Hafuite, 1716. ^ 476, 1846, ii., 699. c 125, vii., 501. 


Instances of triple dentition late in life are qnite numerous, many occur- 
ring after a hundred years. Mentzelius speaks of a man of one hundred and 
ten who had nine new teeth. Lord Bacon cites the case of a Countess Desmond, 
who when over a century old had two new teeth ; Hufeland saw an instance of 
dentition at one hundred and sixteen ; Xitzsch speaks of one at one hundred, 
and the Ephemerides contain an account of a triple dentition at one hundred 
and twenty. There is an account " of a country lal)orer who lost all his teeth 
by the time he arrived at his sixtieth year of age, but al)out a half year after- 
ward a new set made their apjjearance. Bisset '^ mentions an account of an 
old Avoman who acquired twelve molar teeth at the age of ninety-eight. Carre ^ 
notes a case of dental eruption in an individual of eighty-five. Mazzoti 
speaks of a third dentition, and Ysabeau "^ writes of dentition of a molar at 
the age of ninety-two. There is a record of a physician of the name of Slave 
who retained all his second teeth until the age of eighty, when they fell out ; 
after five years another set appeared, which he retained until his death at one 
hundred. In the same report^ there is mentioned an old Scotchman who 
died at one hundred and ten, whose teeth were renewTd at an advanced age 
after he had lost his second teeth. One of the older journals -^^ speaks of 
dentition at seventy, eighty-four, ninety, and one hundred and fourteen. The 
Philosophical Transactions of London contain accounts of dentition at seventy- 
five and eighty-one. Bassett ^ tells of an old woman who had twelve molar teeth 
at the age of eighty-eight. In France there is recorded dentition at eighty- 
five s and an account of an old. man of seventy-three who had six new teeth, ^ 
Von Helmont relates an instance of triple dentition at the same age. There 
is recorded in Germany an account of a woman of ninety who had dentition 
at forty-seven and sixty-seven, each time a new set of teeth appearing ; 
Hunter and Petrequin have observed similar cases. Carter ^ describes an ex- 
ample of third dentition. LisonJ makes a curious observation of a sixth 

Edentulousness. — AVe have already noticed the association of congenital 
alopecia with edentulousness, but, strange to say, Magitot has remarked that 
" riiommc-chien," was the subject of defective dentition. Borellus found 
atrophy of all the dental follicles in a woman of sixty who never had pos- 
sessed any teeth. Fanton-Touvet saw a boy of nine who had never had teeth, 
and Fox a woman who had but four in both jaws ; Tomes cites several similar 
instances. Hutchinson ^ speaks of a child who was perfectly edentulous as 
to temporary teeth, but who had the permanent teeth duly and fully erupted. 
Guilford^ describes a man of forty-eight, who was edentulous from birth, 
who also totally lacked the sense of smell, and was almost without the sense 

a 534, 1784, iii., 105. b 504^ Loud., 1787, viii., 370. c 368, 1860, xv., 585. 

d 460, XXXV., 316 (1766). e 302, vol. iv. f 524, 787. 

g 368, 1860. h 363, Oct. 9, 1875. i 133, 1876. 

J 235, xiii., 190. k 475, 1883, i., 894. 1 296, 1883. 


of taste ; the surface of liis body was covered with tine hairs and he had 
never had visible perspiration. This is probably the same case quoted in the 
foregoing paragraph in regard to the anomalies of hair. Otto, quoted by 
Sedgwick, speaks of two brothers who were both totally edentulous. It 
might be interesting in this connection to note that Oudet found in a fetus at 
term all the dental follicles in a process of suppuration, leaving no doubt that, 
if the fetus had been born viable, it would have been edentulous. Giraldes 
mentions the absence of teeth in an infant of sixteen months. Bronzet 
describes a child of twelve, with only half its teeth, in whom the alveolar 
borders receded as in age. Baumes remarks that he had seen a man who 
never had any teeth. 

The anomalies of excessive dentition are of several varieties, those of 
simple supernumerary teeth, double or triple rows, and those in anomalous 
positions. Ibbetson saw a child with five incisors in the inferior maxillary 
bone, and Fanton-Touvet describes a young lady who possessed five large in- 
cisors of the first dentition in the superior maxilla. Raver " notes a case of 
dentition of four canines, wdiich first made their appearance after pain for eight 
days in the jaws and associated with convulsions. In an Ethiopian Soem- 
mering has seen one molar too many on each side and in each jaw. Ploucquet 
and Tesmer have seen five incisf)rs and Fanchard six. Many persons have 
the supernumerary teeth parallel with their neighbors, anteriorly or posteriorly. 
Costa '" reports a case in which there were five canine teeth in the upper jaw, 
two placed laterally on either side, and one on the right side behind the other 
two. The patient was twenty-six years of age, well formed and in good health. 

In some cases there is fusion of the teeth. Pliny, Bartholinus, and 
Melanthon pretend to have seen the union of all the teeth, making a continu- 
ous mass. In the "Musee de I'ficole dentaire de Paris" there are several 
milk-teeth, both of the superior and inferior maxilla, which are fused together. 
Bloch cites a case in which there were two rows of teeth in the superior 
maxilla. Hellwig^^^ has observed three rows of teeth, and the E])hemerides 
contain an account of a similar anomaly. 

Extraoral Dentition. — Probably the most curious anomaly of teeth is 
that in which they are found in other than normal positions. Albinus speaks 
of teeth in the nose and orl)it ; Borellus, in the palate ; Fabricius Hildanus,'^"^ 
under the tongue ; Schenck, from the palate ; and there are many similar 
modern records. Heister in 1743 wrote a dissertation on extraoral teeth. 
The following is a recent quotation :^ — 

"In the Norsk Magazin fiir Leegevidenskal>en, January, 1895, it is 
reported that Dr. Dave, at a meeting of the ^Medical Society in Christiania, 
showed a tootli removed from the nose of a woman aged fifty-three. The 
patient had consulted him for ear-trouble, and the tooth was found acci- 
dentally during the routine examination. It was easily removed, liaving 

a 302, viii., 411. b 358, March, 1895. <= 224, 1895, ii., 512. 


been situated in a small depression at the junction of the floor and external 
wall of the nasal cavity, 22 mm. from the external nares. This patient had 
all her teeth ; they were placed somewhat far from each other. The tooth 
resembled a milk canine ; the end of the imperfect root was covered with a 
fold of mucous membrane, with stratified epithelium. The speaker suggested 
that part of the mucous membrane of the mouth with its tooth-germ had 
become impacted betsveen the superior and premaxillary bones and thus 
cut oif from the cavity of the mouth. Another speaker criticised this fetal 
dislocation and believed it to be due to an inversion — a development in the 
wrong direction — by which the tooth had grown u})ward into the nose. The 
same speaker also pointed out tliat the stratified epithelium of the mucous 
membrane did not prove a connection with the cavity of the mouth, as it is 
known that cylindric epithelium-cells after irritative processes are replaced 
by flat ones." 

Delpech saw a young man in 1829 who had an opening in the palatine 
vault occasioned by the extraction of a tootli. This opening communicated 
with the nasal fossa by a fracture of the palatine and maxillary bones ; the 
employment of an obturator was necessary. It is not rare to see teeth, 
generally canine, make their eruption from tlu^ vault of the palate ; and 
these teeth are not generally supernumerary, but examples of vice and devia- 
tion of position. Fanton-Touvet, however, gives an example of a super- 
numerary tooth implanted in the palatine arcli. Branch ^ describes a little 
negro l)ov who had two large teeth in the nose ; his dentition was otherwise 
normal, but a portion of the nose was destroyed by ulceration. Hoy '* 
describes a Hindoo lad of fourteen who had a tooth in the nose, sup])osed to 
have been a tumor. It was of the canine t}'pe, and was covered with enamel 
to the junction with the root, which was deeply imbedded in the side and upper 
part of the antrum. The boy had a perfect set of permanent teeth and no 
deformity, swelling, or cystic formation of the jaw. This w^as clearly a case 
of extrafollicular development and eruption of the tooth in an anomalous 
position, the peculiarity being that while in other similar eases the crown of 
the tooth shows itself at the floor of the nasal cavity from below upward, in 
this instance the dental follicle was transposed, the eruption being from 
above downward. Hall ^ cites an instance in which the right upper canine 
of a gii'l erupted in the ncjse. The subject showed marked evidence of 
hereditary syphilis. Carver'^ describes a child wlio had a tooth growing 
from the lower right eyelid. The number of deciduous teeth was perfect ; 
although this tooth Avas canine it had a somewhat bulbulous fang. 

Of anomalies of the head the first to be considered M-ill be the anen- 
cephalous monsters who, strange to say, have been kno\vn to survive l)irth. 
Clericus ^ cites an example of life for five days in a child without a cere- 

a 548, 1884, i., 425. ^ 476, 1883, ii., 772. c 476, 1883, ii., 862. 

d476, 1887, ii., 763. e 215, 1781. 


brum. Hev^iliam ^ recortU the ])irtli of a child without a cerebrum and re- 
marks that it was kept alive for six days. There was a child born alive in Italy 
in 1831 without a brain or a cerebellum — in fact, no cranial cavity — and yet 
it lived eleven hours.'' A somewhat similar case is recorded in the last cen- 
tury. ^*'^ In the Philosophical Transactions'^ there is mentioned a child 
virtually born without a head who lived four days ; and Le Due records a 
case of a child born without brain, cerebellum, or medulla oblongata, and 
who lived half an hour. Brunet^ describes an anencephalous boy born at 
term who survived his birth. Saviard^''^ delivered an anencephalous child at 
term which died in thirty-six hours. Lawrence *-' mentions a child with brain 
and cranium deficient that lived five days. Putnam ^ speaks of a female 
nosencephalous monster that lived twenty-nine hours. Angell and Eisner in 
March, 1895, -■^*' reported a case of anencephaly, or rather pseudencephaly, 
associated with double divergent strabismus and limbs in a state of constant 
spastic contraction. The infant lived eight days. Geoffroy-Saint-Hilaire 
cites an example of anencephaly which lived a quarter of an hour. Fauvel 
mentioned one that lived two hours, and Sue describes a similar instance in 
which life persisted for seven hours and distinct motions were noticed. Mala- 
carne saw life in one for twelve hours, and Mery has given a description of a 
child born without brain that lived almost a full day and took nourishment. 
In the Hotel-Dieu in Paris in 1812 Serres saw a monster of this type which 
lived three days, and was fed on milk and sugared water, as no nurse could 
l)e found who was willing to suckle it. 

Fraser 8 mentions a brother and sister, aged twenty and thirty, respectively, 
who from birth had exhibited signs of defective development of the cere- 
bellum. They lacked power of coordination and walked with a drunken, 
staggering gait ; they could not touch the nose with the finger when their 
eyes were shut, etc. The parents of these unfortunate persons were perfectly 
healthy, as were the rest of their family. Cruveilhier cites a case of a girl of 
eleven who had absolutely no cerebellum, with the same symptoms Avhich are 
characteristic in such cases. There is also recorded the history of a man*^ 
who was deficient in the corj)us callosum ; at the age of sixty-two, though of 
feeble intelligence, he presented no signs of nervous disorder. Claude 
Bernard made an autopsy on a woman who had no trace of olfactory lobes, 
and after a minute inquiry into her life he found that her sense of smell had 
been good despite her deficiency. 

Buhring relates the history of a case somewhat analogous to viability of 
anencephalous monsters. It was a bicephalous child that lived thirty-two 
hours after he had ligated one of its heads. ' 

AVardJ mentions an instance of congenital absence of the corpora callo- 

a 524, iii., 250. b 476, 1832-3, i., 570. c 629, 1700, 23. *^ Progres de la Med., 1698. 

e 550, 1814. f Archiv. ScieDtif. and Prac. M. & S., 1873, 342. 

g 381, 1880, 199. 51212, 158. i 827, Oct., 1843. J 490, 1846, n., 575. 


sura. Paget ^ and Henry mention cases in which the corpora callosum, the 
fornix, and septum hicidum were imperfectly formed. Maunoir^ reports con- 
genital malformation of the brain, consisting of almost complete absence of 
the occipital lobe. The patient died at the twenty-eighth month. Combettes '^ 
reports the case of a girl who died at the age of eleven who had complete 
absence of the cerebellum in addition to other minor structural defects; this 
was probably the case mentioned by Cruveilhier.'^ 

Diminution in volume of the head is called microcephaly. Probably 
the most remarkable case on record is that mentioned by Lombroso. The 



Fig. 91. — Microcephalic "Aztec man." 

individual was called " I'homme-oiseau," or the human bird, and his cranial 
capacity was only 390 c. c. Lombroso speaks of another individual 

a 550, xxix., 55. b 042, i876, i., 163. c 242, 1830, v., 148. 

'1 The argument that the braiu is not the sole organ of the mind is in a measure sub- 
stantiated by a wonderful case of a decapitated rooster, reported from Michigan.^ A stroke 
of the knife had severed the larynx and removed the whole mass of the cerebrum, leaving 
the inner aspect and base of the skull exposed. The cerebrum was partly removed ; tlie 
external auditory meatus was preserved. Immediately after the decapitation the rooster was 
left to its supposed death struggles, but it ran headless to the barn, where it was secured and 
subsequently fed by pushing corn down its esophagus, and allowing water to trickle into this 
tube from the spout of an oilcan. The phenomena exhibited by the rooster were quite 
interesting. It made all the motions of pecking, strutted about, flapped its wings, attempted 
to crow, but, of course, without making any sound. It exhibited no signs of incoordination, 
but did not seem to hear. A ludicrous exhibition was the absurd, sidelong pas seul made 
toward the hens. 

»632, 1880, ii., 5. 



called " I'liomrae-lapin," or man-rabbit, whose cranium was only slightly 
larger than that of the other, measuring 490 mm. in circumference. Castelli 
alludes to endemic microcephaly among some of the peoples of Asia. AVe 
also find it in the Caribbean Islands, and from the skulls and portraits of the 
ancient Aztecs we are led to believe that they were also microceplialic. 

Two creatures of celebrity were Maximo and Bartola, who for twenty- 
five years have been shown in America and in Europe under the name of the 
"Aztecs" or the "Aztec cluldren " (Fig. 91). They were male and 
female and very short, with heads resembling closely the bas-reliefs on the 

ancient Aztec temples of Mexico. Their 
facial angle was about 45°, and they had 
jutting lips and little or no chin. Tliey 
wore their hair in an enormous bunch to 
magnify the deformity. These curiosities 
were l)orn in Central America and were 
possibly half Indian and Xegro. They 
were little better than idiots in point of 

Figure 92 represents a microcephalic 
youth known as the " jNIexican wild bov," 
who was shown with the Wallace circus. 
Virchow •' exhibited a girl of four- 
teen whose face was no larger than that 
of a new-born child, and whose head 
was scarcely as large as a man's fist. 
INIagitot reported a case of a micro- 
cephalic woman of thirty M'ho weighed 
70 pounds. 

Hippocrates and Stralionius both 
speak of head-lunding as a custom in- 
ducing artificial microcephaly, and 
some tribes of North American Indians 
still retain this custom. 

As a rule, microcephaly is attended 
with associate idiocy and arrested development of the rest of the body. 
Ossification of the fontanelles in a mature infant would necessarily prevent 
full development of the brain. Osiander and others have noticed this 
anomaly. There are cases on record in which the fontanelles have remained 
open until adulthood. 

Augmentation of tlie volume of tlie head is called macrocephaly, and 
there are a number of curious examples related. Benvenuti describes 
an individual, otherwise well formed, whose head began to enlarge at 

a Quoted 538, 1884, 522. 

Fig. 92. — Microcephalic hoy. 


seven. At twenty-seven it measured over o7 inches in circumference 
and the man's face was 15 inches in height ; no other portion of his Ijody 
increased abnormally ; his voice was normal and he was very intelligent. 
He died of apoplexy at the age of tliirty.'"^ 

Fournier '' speaks of a cranium in the cabinet of the Natural History 
Museum of Marseilles of a man by the name of Borghini, who died in 1616. 
At the time he was described he was fifty years old, four feet in height ; his 
head measured three feet in circumference and one foot in height. There was 
a proverb in ^Marseilles, '* Apas mai de sen que Borghini," meaning in the 
local dialect, " Thou hast no more wit than Borghini." This man, whose fame 
became known all over France, was not able, as he grew older, to maintain 
the weight of his head, but carried a cushion on each shoulder to prop it 
up. Fournier also quotes the history of a man who died in the same city in 
1807 at the age of sixty-seven. His head was enormous, and he never lay 
on a bed for thirty years, passing his nights in a chair, generally reading or 
writing. He only ate once in twenty- four or thirty hours, never warmed 
himself, and never used warm water. His knowledge was said to have been 
great and encyclopedic, and he pretended never to have heard the proverl) of 
Borghini. There is related the account of a Moor, who was seen in Tunis 
early in this century, thirty-one years of age, of middle height, with a head 
so prodigious in dimensions that crowds flocked after him in the streets. 
His nose was quite long, and his mouth so large that he could eat a melon as 
others would an apple. He was an imbecile. AVilliam Thomas Andrews 
was a dwarf seventeen years old, whose head measured in circumference 35 
inches; from one external auditory meatus to another, 27 J inches; from the 
chin over the cranial summit to the suboccipital protuberance, Z1^ inches ; 
the distance from the chin to the pubes was 20 inches ; and from the pubes 
to the soles of the feet, 16 ; he was a monorcliid.'^ James Cardinal, who died 
in Guy's Hospital in 1825, and who was so celebrated for the size of his 
head, only measured 32^ inches in head-circumference. 

The largest healthy brains on record, that is, of men of prominence, 
are those of Cuvier, weighing 64|^ ounces ; '' of Daniel Webster, weighing 63| 
ounces (the circumference of whose head was 23f inches) ; ® of Abercrombie, 
weighing 63 ounces, and of Spurzheim, weighing ^'i^^-^; ounces. Byron and 
Cronnvell had abnormally heavy brains, showing marked evidence of disease. 

A curious instance in this connection is that quoted by Pigne,*^ who gives 
an account of a double brain found in an infant. Keen reports finding a 
fornix which, instead of being solid from side to side, consisted of two lateral 
halves with a triangular space between them. 

When the augmentation of the volume of the cranium is caused by an 
abundant quantity of serous fluid the anomaly is known as hydrocephaly. 

a Actes de la societe imper. des curieux de la nature, torn. viii. ti 302, iv.. 142. 

c 593, 1856, xiii., 778. d 678, Dec, 1883. e 124^ 1353^ no. f 242, 1846, xxi., 144. 



In this condition there is usually no clianire in the size of the brain-structure 

itself, but often the cranial 

bones are rent far asunder. 
Minot speaks of a hydro- 
cephalic infant whose head 
measured 27|^ inches in cir- 
cumference ; Bright describes 
one whose head measured 32 
inches ; and Klein, one 43 
inches. Figure 93 represents 
ci child of six whose head cir- 
cumference was 36 inches. 
Figure 94 shows a hydro- 
cephalic adult who was ex- 
hibited through this country. 

There is a record * of a 
curious monster born of healthy 
half-caste African parents. 
The deformity was caused by 
a deficiency of osseous ma- 
terial of the bones of the head. There was considerable arrest of develop- 

1'',-. 'j:;.— Hydrocephalic cliiM. 

I'ig. 'J4. — Hydrocephaly in an adult. 

ment of the parietal, temporal, and superior maxillar}^ bones, in consequence 
of which a very small amount of the cerebral substance could be protected by 

a 778, 1868, ix., 31. 



tlie membranous expansion of the cranial centers. The inferior maxilla and 
the frontal bone were both perfect ; the ears were well developed and the 
tongue strong and active ; the nos- 
trils were imperforate and there 
was no roof to the mouth nor floor 
to the nares. The eyes were curi- 
ously free from eyelashes, eyelids, 
or brows. The cornea threatened 
to slough. There was double hare- 
lip on the left side ; the second and 
third fingers of both hands were 
webbed for their whole length ; the 
right foot wanted the distal phalanx 
of the great toe and the left foot 
was clubbed and drawn inward. 
The child swallowed when fed from 
a spoon, appeared to hear, but ex- 
hibited no sense of light. It died 
shortly after the accompanying 
sketch (Fig. 95) was made. 

Occasionally a deficiency in the 
osseous material of the cranium or 
an abnormal dilatation of the fon- 
tanelles gives rise to a hernia of 

the meninges, which, if accompanied by ccrebrosi)inal tluid in any quantity, 
causes a large and peculiarly shaped tumor called meningocele (Fig. 96), 
If there is a protrusion of brain-substance itself, a condition known as hernia 
cerebri results. 

Complete absence of the inferior maxilla is 
nuich rarer in man than in animals. Nicolas and 
Prenant have described a curious case of this anomaly 
ill a sheep. Gurlt has named subjects presenting the 
total or partial absence of the inferior maxilla, agna- 
tlies or hemiagnathes. Simple atrophy of the inferior 
maxilla has been seen in man as well as iii the lower 
animals, but is much less frequent than atrophy of the 
superior maxilla. Langenbeck reports the case of a 
young man who had the inferior maxilla so atrophied 
that in infancy it was impossible for him to take milk 
from the breast. He had also almost complete im- 
Boullard-'' reports a deformity of the visage, resulting 
in a deficiency of the condyles of the lower jaw. ^Maurice'' made an ol^serva- 
a 242, 1849, xxiv., 281. ^ 146, 1861, i., 696. 

Fig. 95. — Mocster from deficiencj' of the bones of the 

Fig. 96. — ileuingocele. 

moljility of the jaws 



tion on a vice of conformation of the lower jaw which rendorcfl lactation 
impossible, probably causing the death of the infant on this account. Tomes 
gives a description of a lower jaw the development of the left ramus of 
which had been arrested. Canton =' mentions arrest of development of the 
left perpendicular ramus of the lower jaw coml)ined with malformation of 
the external ear. 

Exaggerated prominence of the maxillaries is called prognathism ; that 
of the superior maxilla is seen in the North American Indians. Inferior 
prognathism is observed in man as well as in animals. The bull-dog, for 
example, displays this, but in this instance the deformity is really superior 
brachygnathism, the superior maxilla being arrested in development. 

Congenital absence of the nose is a very rare anomaly. ]\Iaisonneuve 
has seen an example in an individual in whicli, in place of the nasal appen- 
dix, there was a plane surface perforated by two 
small openings a little less than one mm. in diam- 
eter and tliree mm. apart. 

Exaggeration in volume of the nose is quite 
frequent. Ballonius ^^^ speaks of a nose six times 
larger than ordinarv. Viewing the Roman celebri- 
ties, we find that Numa, to whom was given the 
surname Pompilius, had a nose which measured six 
inches. Plutarch, Lycurgus, and Solon had a 
similar enlargement, as had all the kings of Italy 
except Tanpiin the Superb. 

Early in the last century a man, Thomas AVed- 
ders (or AVadhouse), with a nose 7 J inches long, was 
exhibited throughout Yorkshire. This man expired 
as he had lived, in a condition of mind best de- 
scribed as the most abject idiocy. The accompany- 
ing illustration (Fig. 97) is taken from a reproduction of an old print and is 
supposed to be a true likeness of this unfortunate individual. 

There are curious pathologic formations about the nose wliich increase its 
volume so enormously as to interfere with respiration and even with alimen- 
tation ; but these will be spoken of in another chapter. 

There have been some celebrities whose noses were undersized. The Due 
de Guise, the Dauphin d'Auvergne, and William of Orange, celebrated in the 
romances of chivalry, had extremely short noses. 

There are a few recorded cases of congenital division of the nose. 
Bartholinus,** Borellus, and the Ephemerides speak of duplex noses. Thomas 
of Tours has observed congenital fissure of the nose. Riker*^ reports the 
case of an infant of three weeks who possessed a supernumerary nose on the 
right nasal bone near the inner canthus of the eye. It was pear-shaped, with 
a 779, xii., 237. 'j 190, cent, i., hist. xxv. c 176, 1878, 196. 

Fig. 97. — Tliomas Wedders. 



its base down, and was the size of the natural nose of an infant of that age, 
and air })assed tlirough it. IIubl)('ll, Ronaldson,-' and Luscha spealv of con- 
genital occlusion of the posterior nares. Smith '^ and Jar vis'' record 
cases of congenital occlusion of the anterior nares. 

Anomalies in size of the mouth are not uncommon. Fournier quotes 
the history of a man who had a mouth so large that when he opened it all his 
back teeth could be seen. There is a history of a boy of seventeen '^ who had 
a preternaturally-sized mouth, the transverse diameter being 6J inches. The 
motlier claimed that the boy was born with his foot in his mouth and to this 
fact attributed his deformity. The negro races are noted for their large 
mouths and thick lips. A negro called ^'- Black Diamond," recently exhibited 
in Philadelphia, could put both his fists in his mouth. 

Morgan*' reports two cases of congenital macrostoma accompanied by 

Fig. 98. — Macrostoma by ascending 
lateral Assure. 

Fig. 99. — Macrostoma by lateral 

malformation of the auricles and by auricular appendages. Van Duyse^ 
mentions congenital macrostoma with preauricular tumors and a dermoid of 
the eye. Macrostoma is sometimes produced by lateral fissures (Fig. 99). 
In other cases this malformation is unilateral and the fissure ascends (Fig. 
98), in which instance the fissure may be accompanied by a fistula of the duct 
of Stensen. Sometimes there is associated with these anomalies curious termi- 
nations of the salivary ducts, either through the cheek by means of a fistula 
or on the anterior part of the neck. 

Microstoma. — There are a few cases on record in which the mouth has 
been so small or ill-defined as not to admit of alimentation. Molliere knew 
an individual of forty whose mouth was the exact size of a ten-centime piece. 

Buchnerus ^ records a case of congenital atresia of the mouth. Cayley, 

a 318, 1880, xxvi., 1035. b 548, 1863, i., 320. c 597^ xlvi., 536. d 206, vol. iv., part iii. 
e 548, 1881, ii., 613. f Ann. Soc. de med. de Gand., 1882, 141. g 105, 1730, ii., 210. 



i m^^^^mmMi. 

Smith,'* Sourrouille/^ and Stankiewicz of AVarsaw discuss atresia of the 
mouth. Caiicrum oris, scarlet fever, bums, scurvy, etc., are occasional 
causes that have been mentioned, the atresia in these instances taking place 
at any time of life. 

Anomalies of the Lips. — The aboriginal tribes are particularly noted 
for their large and thick lips, some of which people consider enormous lips 
signs of adornment. Elephantiasis or other pathologic hypertrophy of the 
labial tissues can produce revolting deformity, such as is seen in Figure 100, 
representing an individual who was exhibited several years ago in Philadel- 
phia. We have in English the expression, " pulling a long lip." Its origin 
is said to date back to a semimythical hero of King Arthur's time, who, 
" when sad at heart and melancholic," would let one of his lips drop below 
his waist, while he turned the other up like a cap on his head. 

Blof^ records a case of monstrous congenital hypertrophy of the superior 

lip in an infant of eight months. Buck ^ 
successfully treated by surgical operations 
a case of congenital hypertro])hy of the 
under lip, and Detmold " mentions a similar 
result in a young lady with hypertrophy 
of the lip and lower part of the nose. 
Murray ' reports an nndescribed malforma- 
tion of the lower lip occurring in one family. 
Weiss has reported cases of exstrophv of the 

Hare-lip may l)e unilateral or double, 

and may or may not include the palatine 

arch. In the worst cases it extends in 

fissures on Ixith sides to the orbit (Fig. 

101). In other cases the minimum degree of this deformity is seen (Fig. 


Congenital absence of the tongue does not necessarily make speech, 
taste, or deglutition impossible. Jussieu cites the case of a girl who was born 
without a tongue but who spoke very distinctly, Berdot« describes a case 
in which the tongue was deficient, without apparent disturbance of any of the 
functions. Riolan mentions speech after loss of the tongue from small-pox. 
Boddington ^ gives an account of Margaret Cutting, who spoke readily and 
intelligil)ly, although she had lost her tongue. Saulquin ' has jin observation 
of a girl without a tongue who spoke, sang, and swallowed normally. Aur- 
ran, Bartholinus, Louis, Parsons, Tulpius, and others mention speech with- 
out the presence of a tongue. 

Fig. 100.— Elephantiasis of the face, with 
hypertroijhy of the upper lip. 

a 476, 1876, i., 13. b 363, Ivi.. 707, c Bull. Soc. de chir. de Par.. 1873. ii., 332. 
d773, 1882, 171. e 594, 1844. iii., 38. f 222, 1860. xxvi., 502. 

g 107, vol. viii.. 185. b 629, 1732-44, ix., 126. i 460, 1764, xx., 328. 



Philib ^ reports a ease in which mutism, ahnost simuhiting that of one eon- 
genitally deaf, was tlue to congenital adhesions of the tongue to the floor 
of the buccal cavity. Speech was estal)lishe(l after removal of the abnormal 
adhesion. Routier speaks of ankylosis of the tongue of seventeen years' 

Jurist ^ records such abnormal mobility of the tongue that the patient 
was able to project the tongue into the nasopharynx. \\ herry and Winslow 
record similar instances. 

There have l^een individuals with bifid tongues, after the normal type of 
serpents and saurians, and others who possessed a supernumerary tongue. 
Rev. Henry Wharton, Chaplain to Archbishop Sancroft, in his journal, writ- 
ten in the seventeenth century, says that he was Ijorn with two tongues and 

Fig. 101.— Double hare-lip. 

Fig. 102.— Slight hare-hp, with fissure of the 
lower eyelid (Kraske). 

passed through life so, one, however, gradually atrophying. In the poly- 
clinic of Schnitzer in Vienna in 1892 Hajek observed in a lad of twelve an 
accessory tongue 2.4 cm. in length and eight mm. in breadth, forming a tumor 
at the base of the normal tongue. It was removed by scissors, and on histo- 
logic examination proved to be a true tongue with the typical tissues and 
constituents. Borellus, Ephemerides, Eschenbach, Mortimer,'' Penada, and 
Schenck speak of double tongues, and Avicenna and Scheiick have seen fis- 
sured tongues. Dolaeus "^ records an instance of double tongue in a paper 
entitled " De puella bilingui," and Beaudry and Brothers^ speak of cleft 

a 454, 1829, xxxiii., 265. 
c 629, 486. 

<128U, 1755, iii., 411. 

b5.'58, xxviii., 539. 
e 538, xxxiii., 109. 


tongue. Braine ^ records a case in which there was a large livperti'opliied 
fold of membrane coming from each side of tlic upper li]>. 

In some cases there is marked augmentation of the volume of the 
tongue. Fournier '' has seen a juggler with a tongue so long that he could 
extrude it six inches from his mouth. He also refers to a woman in Berlin 
with a long tongue, but it was thinner than that of a cat. When she laughed 
it hung over her teeth like a curtain, and was always extremely cold to the 
touch. In the same article there is a description of a man with a very long 
neck who could touch his tongue to his chest without reclining his head. 
Congenital and accjuired hypertrophy of the tongue will be discussed later. 

Amatus Lusitanus ° and Portal '^ refer to the presence of hair on the 
tongue, and later there was an account of a medical student ^ who com- 
plained of dyspepsia and a sticky sensation in the mouth. On examination a 
considerable growth of hair was found on the surface of the tongue. The 
hairs would be detached in vomiting but would grow again, and when he 
was last seen thev were one inch long. Such are possibly nevoid in formation. 

The ordinary anomalies of the palate are the fissures, unilateral, bilat- 
eral, median, etc. : they are generally associated with liare-lip. The median 
fissure commencing between the middle incisors is quite rare. 

!Many curious forms of obturator or artificial palate are employed to 
remedy congenital defects. Sereombe' mentions a case in which destruction 
of the entire palate was successfully relieved by mechanical means. In some 
instances among the lower classes these obturators are simple pieces of wood, 
so fashioned as to fit into the palatine cleft, and not infrequently the obturator 
has been swallowed, causing obstruction of the air-passages or occluding the 

Abnormalism of the Uvula. — Examples of double uvula are found in 
the older writers, and Hagendorn speaks of a man who was born without a 
uvula. The Ephemerides and Salmuth describe uvula so defective as to be 
hardly notieeal)le. Bolster, Delius, Hodges, Mackenzie of Baltimore, Orr, 
Riedel, Schufeldt, and Tidy man are among observers reporting l)ifurcated 
and double uvula, and they are quite common. Ogle s records instances of 
congenital absence of the uvula. 

Anomalies of the Epiglottis. — ^lorgagni mentions a man without an 
epiglottis who ate and spoke witliout difiieulty. He thought the arytenoids 
were so strongly developed that they replaced the functions of the missing 
organ. Enos of Brooklyn in 1854 reported absence of the. epiglottis with- 
out interference with deglutition.'^ ^Manifold ^ speaks of a case of 1)ifur- 
cated epiglottis. DebloisJ records an instance of congenital web of the 

a Proc. M. Soc. Lond., 1874-5, ii., 21. *> 302, iv., 149. 

c 119, cent. vi.. cur. 65. d 639, iv., 507. e 611, Aug. 13, 1842. 

f 550, xxxix.. 91. g 548, 1865, ii., 414. b 230, 1864, iv., .353. 

i 476, 1851, i., aO. J 597, xxxix., 660. 



vocal bands. ^lackenzie ■' removed a congenital papillomatous web 
Avliich had united the vocal cords until the age of twenty-three, thus establish- 
ing the voice. Poore also recorded a case of congenital web in the larynx. 
Elsberg and Schetf mention occlusion of the rima glottidis by a membrane. 

Instances of duplication of the epiglottis attended with a species of 
double voice i)osses.s great interest. French'' described a man of thirty, by 
occupation a singer and contortionist, who became possessed of an extra voice 
when he was sixteen. In high and falsetto tones he could run the scale from 
A to F in an upjier and lower range. The compass of the low voice was so 
small that he could not reach the high notes of any song with it, and in sing- 
ing he only used it to break in on the falsetto and produce a sensation. He 
was supposed to possess a double epiglottis. ° 

Roe '^ describes a young lady who could whistle at will with tlie lower 
part of her throat and without the aid of her lips. Laryngeal examination 
showed that the fundamental tones were produced by vibrations of the edges 
of the vocal cords, and the modifications were eifected by a minute adjust- 
ment of the ventricukir bauds, which regulated the laryngeal opening above 
the cord, and pressing firmly down closed the ventricle and acted as a damper, 
preventing the vil)rati()ns of the cords except in their middle third. ^lorgan 
in the same journal mentions the case of a boy of nineteen, who seemed to 
be aifected with laryngeal catarrh, and who exhibited distinct diphthongia. 
He Avas seen to have two glottic orifices with associate bands. The treatment 
was directed to the catarrh and consecpient paresis of the })osterior bands^ 
and he soon lost his evidences of double voice." 

Com})lete absence of the eyes is a very rare anomaly. AVordsAvorth ^ 
describes a baby of seven weeks, otherwise well formed and healthy, M'hich 
had congenital absence of both eyes. The parents of this child were in every 
respect healthy. There are some cases of monstrosities with closed, adherent 
eyelids and absence of eyes.^ Holmes ^ reports a case of congenital absence of 
both eyes, the child otherwise being strong and perfect. The child died of 

a 224, 1874, i., ?,V7. b Quoted 224, 1880, ii., 311. 

c 148, vol. ii., 271. J Archives of Laryugologj^, Jan. 1, 1882. 

e The foUowiag is ii description of the laiyngeal formation of a singer who has recently 
ac(iuired considerable notice by her abilitj' to sing notes of the highest tones and to display 
the greatest compass of voice. It is extracted from a Cleveland, Ohio, newspaper: "She 
has unusual development of the larynx, which enables her to throw into vibration and with 
different degrees of rapidity the entire length of the vocal cords or only a part thereof. But 
of greatest interest is her remarkable control over the muscles Avluch regulate the division and 
modification of the resonant cavities, the laryngeal, pliaryngeal, oral,' and nasal, and uj)on 
this depends the qualitj' of her voice. The uvula is bifurcated, and the two divisions some- 
times act independently. The epiglottis during the production of the highest notes rises 
upward and backward against the posterior pharyngeal wall in such a way as almost entirely 
to separate the pharyngeal cavities, at the same time that it gives an unusual couformation 
to those resonant chambers." 

f 476, 1881, ii., 875. g 240, 1828. h 268, 1869, xxvi., 163. 



cholera infantum. He also reports a case very similar in a female child of 
American parents. In a girl of eight, of German parents, he reports defi- 
ciency of the external walls of each orbit, in addition to great deformity of 
the side of the head. He also gives an instance of congenital paralysis of the 
levator palpebrse muscles in a child whose vision was perfect and who was 
otherwise perfect. Holmes also reports a case of enormous congenital ex- 
ophthalmos, in which the riglit eye protruded from the orbit and was no 
longer covered by the cornea. Kinney ^ has an account of a child born 
without eyeballs. The delivery was normal, and there was no liistory of any 
maternal impression ; the child was otherwise healthy and well formed. 

Landes^ reports the case of an infant in which both eyes were absent. 
There were six fingers on each hand and six toes on each foot. The child 
lived a few weeks. In some instances of supposed absence of the eyeball the 
eye is present but diminutive and in the posterior portion of the orbit. 
There are instances of a single orbit with no eyes and also a single orbit 
containing two eyes.'' Again we may have two orbits with an absence of 
eyes but the presence of the lacrimal glands, or the eyes may be present or 
very imperfectly developed. ]Mackenzie mentions cases in which the orbit 
was more or less completely wanting and a mass of cellular tissue in each eye. 

Cases of living cyclopia, or individuals with one eye in the center of 
the forehead a iter the manner of the mythical Cyclop.s, are quite rare. Val- 
lentini in 1884*^ reports a case of a male cyclopic infant which lived for 
seventy-three hours. There were median fissures of the upper lip, pre- 
auricular appendages, oral deformity, and absence of the olfactory proboscis. 
The fetus was therefore a cyclops arrhynchus, or cyclocephalus. Blok ^ de- 
scribes a new-born infant which lived for six or seven hours, having but one 
eye and an extremely small month. 

The "Four-eyed Man of Cricklade " was a celebrated English mon- 
strosity of whom little reliable information is obtainable. He was visited by 
W. Drury, who is accredited with reporting the following : — 

" ' So wondrous a thing, such a lusus naturse, such a scorn and spite of 
nature I have never seen. It was a dreadful and shocking sight.' This 
unfortunate had four eyes placed in pairs, ' one eye above the other and all 
four of a dull brown, encircled with red, the pupils enormously large.' The 
vision in each organ appeared to be perfect. ' He could shut any particular 
eye, the other three remaining open, or, indeed, as many as he chose, each 
several eye seeming to l^e controlled l)y his will and acting incLejiendently of 
the remainder. He could also revolve each eye separately in its orbit, look- 
ing backward with one and forward Avith another, upward with one and 

a 218, 1854, li., 25. b 538, Nov. 3, 1894. c 418, 1751, 49. 

d Atti dell' Accad. med.-cliir. di Perugia, vi., fasc. 3 & 4, 1894. 

« Weekblad van het Nederlandsch Tijdst-Lr. voor Gciiceskuude, xxx., 2d part, 414, 
Sept, 1894 ; also extracted in 759. 


downward with another simultaneously.' He was of a savage, malignant 
disposition, delighting in ugly trieks, teasing children, torturing helpless ani- 
mals, uttering profane and blasphemous words, and acting altogether like the 
monster, mental and physical, that he was. ' He could play the fiddle, 
though in a silly sort, having his notes on the left side, while closing the 
right pair of eyes. He also sang, but in a rough, screeching voice not to be 
listened to without disgust.' " 

There is a recent report ^ of a child born in Paris with its eyes in the top 
of its head. The infant seemed to be doing well and crowds of peo})le have 
flocked to see it. Recent reports speak of a child born in Portland, Ore- 
gon, which had a median rudimentary eye between tvvo normal eyes. Four- 
nier describes an infant born with perfectly formed eyes, but with adherent 
eyelids and closed ocular aperture. Forlenze has seen the pupils adherent 
to the conjunctiva, and by dissection has given sight to the subject. 

Dubois ^ cites an instance of supernumerary eyelid. At the external 
angle of the eyelid was a fold of conjunctiva which extended 0.5 cm. in front 
of the conjunctiva, to which it did not adhere, therefore constituting a fourth 
eyelid. Fano '^ presents a similar case in a child of four months, in whom no 
other anomaly, either of organs or of vision, was observed. On the right 
side, in front of the external half of the sclerotic, was observed a semilunar 
fold with the concavity inward, and which projected much more when the 
lower lid was depressed. When the eyelid rolled inward the fold rolled with 
the globe, l)ut never reached so far as the circumference of the cornea and 
did not interfere with vision. 

Total absence of both irides has been seen in a man of eighteen. ^^ 
Dixon reports a case of total aniridia with excellent sight in a woman of 
thirty-seven.'^ In Guy's Hospital there was seen a case of complete con- 
genital absence of the iris.'^^- Hentzschel ^ speaks of a man with congenital 
absence of the iris who had five children, three of whom exhibited the same 
anomaly while the others were normal. Benson, Burnett, Demaux, I^awson, 
Morison, Keuling, Samelson, and others also report congenital deficiency of 
the irides in both eyes. 

Jeaffreson^^ describes a female of thirty, living in India, who was 
affected with complete ossification of the iris. It was immovable and 
quite beautiful when seen through tlie transparent cornea ; the sight was only 
slightly impaired. No cause was traceable. 

Multiple Pupils. — ^lore than one pupil in the eye has often been 
noticed, and as many as six have been seen. They may be jCongenital or due 
to some pathologic disturbance after birth. Marcellus Donatus ^*"' speaks of 
two pupils in one eye. Beer, Fritsche, and Heuermann are among the older 
writers who have noticed supernumerary pupils. Higgens in 1885 described 

•I Amer. Med. Review, Dec, 1895. b 145, vol. xxxiv. c 145^ 1863, 1. 

d 476, 1882, i., 265. e 543, 1858, ii., 35. f Quoted 476, 1830-1, i., 384. 


a boy whose right iris was perforated by four pupils, — one above, one to the 
inner side, one below, and a fourth to the outer side. The first three Avere 
slit-shaped ; tlie fourth was the largest and had the appearance as of the 
separation of the iris from its insertion. There were two pupils in the left 
eye, both to the outer side of the iris, one being slit-like and the other resem- 
bling the fourth pupil in the right eye. All six pupils connnenced at the 
periphery, extended inward, and were of different sizes. The fundus could 
be clearly seen through all of tlie pupils, and there was no posterior staphy- 
loma nor any choroidal changes. There was a rather high degree of nivopia. 
This peculiarity was evidently congenital, and no traces of a central pupil nor 
marks of a past iritis could be found. Clinical Sketches '"^ contains quite an 
extensive article on and several illustrations of congenital anomalies of the 

Double crystalline lenses are sometimes seen. Fritsch and Yalisneri 
have seen this anomaly and there are modern references to it. AVordsw(n'th ^ 
presented to the Medical Society of Ijondon six nu'ml)crs of one familv, all 
of whom had congenital displacement of the crystalline lens outward 
and upward. The family consisted of a woman of fifty, two sons, thirtv-five 
and thirty-seven, and three grandchildren — a girl of ten and boys of five 
and seven. The irides were tremulous. 

Clark ^ reports a case of congenital dislocation of both crystalline 
lenses. The lenses moved freely through the pu})il into the anterior cham- 
bers. The condition remained uncliano;ed for four vears, when elaucoma 

Differences in Color of the Two Eyes. — It is not uncommon to see 
people with different colored eyes. Anastasius I. had one black eye and the 
other blue, from w^hence he derived his name " Dicore," by which this 
Emperor of the Orient was generally known. Two distinct colors have been 
seen in an iris. Berry gives a colored illustration of such a case. 

The varieties of strabismus are so common that they will be passed with- 
out mention. Kuhn '' presents an exhaustive analysis of 73 cases of congeni- 
tal defects of the movements of the eyes, considered clinically and didacti- 
cally. Some or all of the muscles may be absent or two or more nuiy be 
amalgamated, with anomalies of insertion, false, doul)l(', or degenerated, etc. 

The influence of heredity in the causation of congenital defects of 
the eye is strikingly illustrated by De Beck.^ In three generations twelve 
members of one family had either coloboma iridis or iriderejnia. He per- 
formed two operations for the cure of cataract in two brothers. The opera- 
tions were attended with difficulty in all four eyes and followed by cyclitis. 
The result was good in one eye of each patient, the eye most recently blind. 
Posey ^ had a case of coloboma in the macular region in a patient who had a 

a 275, April, 1895. I) 476, 1878, i., 86. c 765, 1894. 

d Beit. z. Augenh., Heft xix., 1895. e Trans. 765, 1894. f 792, Nov., 1894. 


supormimerarv tooth. He believes the defects were inherited, as the patient's 
mother also had a supernumerary tooth. 

Nuunelv'^ reports cases of congenital malformation in three children of 
cue family. The globes of two of them (a boy and a girlj were smaller 
than natural, and in the boy in addition were flattened by the action of the 
recti muscles and w^ere soft ; the sclera were very vascular and the cornese 
conical, the irides dull, thin, and tremulous ; the pupils were not in the axis 
of vision, but were to the nasal side. The elder sister had the same congeni- 
tal condition, but to a lesser degree. The other boy in the family had a total 
absence of irides, l)ut he could see fairly well with the left eye. 

Anomalies of the Ears. — Bilateral absence of the external ears is quite 
rare, although there is a species of sheep, native of China, called the " Yung- 
ti," in which this anomaly is constant. Bartholinus, Lycosthenes, Pare, 
Schenck, and Oberteuifer have remarked on deficient external ears. Guys, 
the celebrated Marseilles litterateur of the eighteenth century, was born with 
onlv one ear. Chantreuil ^ mentions obliteration of the external auditory canal 
in the new-born. Bannofont reports a case of congenital imperforation of 
the left auditory canal existing near the tympanic membrane with total deaf- 
ness in that ear. Lloyd ^ described a fetus showing absence of the external 
auditory meatus on both sides. Munro ^^ reports a case of congenital absence 
of the external auditory meatus of the right ear ; and Richardson *^ speaks 
of congenital malformation of the external auditory apparatus of the right 
side. There is an instance ^ of absence of the auditory canal with but par- 
tial loss of hearing. Mussey ^ reports several cases of congenitally deficient 
or absent aural appendages. One case was that in which there was con- 
genital absence of the external auditory meatus of both ears without much 
impairment of hearing. In neither ear of N. W. Goddard, aged twenty- 
seven, of Vermont, reported in 1834, was there a vestige of an opening or 
passage in the external ear, and not even an indentation. The Eustachian 
tube was closed. The integuments of the fiice and scalp were capable of 
receiving acoustic impressions and of transmitting them to the organs of hear- 
ing. The authors know of a student of a ])rominent New York University 
who is congenitally deficient in external ears, yet his hearing is acute. He 
hides his deformity by wearing his hair long and combed over his ears. 

The knowledge of anomalous auricles is lost in antiquity. Figure 108 
represents the head of an ^?l]gipan in the British Museum showing a super- 
numerary auricle. As a rule, supernumerary auricles are preauricular 
appendages. Warner, in a report of the examination of ^50,000 children, 
quoted by Ballantyne, describes 33 with supernumerary auricles, represented 
by sessile or pedunculated outgrowths in front of the tragus. They are more 
commonly unilateral, always congenital, and can be easily removed, giving rise 

a 550, xlv., 43. t- 242, 1867, xlii., 149. c 779, 1846, i., 139. 

d476, 1869, ii., 41. e 476, 1882, i., 465. f 218, xi., 419. 8 124, 1837, xxi., 378. 



to no unpleasant symptoms. They have a soft and elastic consistency, and 
are usually composed of a hyaline or reticular cartilaginous axis covered with 
connective or adipose tissue and skin bearing- fine hairs ; sometimes both 

cartilage and fat are absent. They are 
often associated with some form of de- 
fective audition — harelip, ocular disturb- 
ance, club-feet, congenital hernia, etc. 
These supernumerary members vary from 
one to five in number and are sometimes 
hereditary. Reverdin describes a man 
having a supernumerary nipple on the 
right side of his chest, of whose five 
children three had preauricular append- 
ages. Figure 104 represents a girl with 
a supernumerary auricle in the neck, de- 
scribed in the Lancet, 1888.=^ A little 
girl under Birkett's care in Guy's Hos- 
pital more than answered to jSIacbeth's 
requisition, " Had I three ears I'd hear 
thee ! " since she possessed two super- 
fluous ones at the sides of the neck, somewhat lower than the angle of 
the jaw, which were well developed as to their external contour and made 
up of fibrocartilage.'' There is mentioned the case of a boy of six months *^ 

Fig. 103.— iEgipan with supernumerary auricle 
(British Museum). 

Fig. 104. — Supernumerary auricle in the neck. 

Fig. 105. — .Supernumerary auricle. 

on the left side of whose neck, over the middle anterior border of the sterno- 
cleidomastoid muscle, was a nipple-like projection ^ inch in length ; a rod of 
a 476, 1888, i., 312. b 543, 1858, 528. c 476, 1889, ii., 1003. 


cartilage was prolonged into it from a thin plate, which was freely movable 
in the subcutaneous tissue, forming a striking analogue to an auricle (Fig. 105). 
]\Ioxhay '^ cites the instance of a mother who was frightened by the sight of a 
bo\ with hideous contractions in the neck, and who gave birth to a child with 
two perfect ears and three rudimentary auricles on the right side, and on the 
left side two rudimentary auricles. 

In some people there is an excessive development of the auricular 
muscles, enabling them to move their ears in a manner similar to that of 
the lower animals. Of the celebrated instances the Abbe de Marolles, says 
Vigneul-Marville, bears witness in his " Memoires " that the Regent Crassot 
could easily move his ears. Saint Augustine mentions this anomaly. 

Double tympanitic membrane is spoken of by Loeseke.^^^ There is 
sometimes natural perforation uf the tympanum in an otherwise perfect ear, 
which explains how some people can bhnv tobacco-smoke from the ear, 
Fournier^ has seen several Spaniards and Germans who could perform this 
feat, and knew one man who could smoke a Avhole cigar without losing any 
smoke, since he made it leave either by his mouth, his ears, or in both ways. 
Fournier in the same article mentions that he has seen a woman with ears 
over four inches long. 

Strange to say, there have been reports of cases in which the ossicles were 
deficient without causing any imperfection of hearing. Caldani'^ mentions 
a case with the incus and malleus deficient, and Scarpa ^^^ and Torreau *' 
quote instances of deficient ossicles. Thomka in 1895 reported a case of 
supernumerary tympanic ossicle, the nature of which was unknown, although 
it was neither an inflammatory product nor a remnant of Meckel's cartilage. 

Absence of the Limbs. — Those persons born without limbs are either 
the subjects of intrauterine amputation or of embryonic malformation. Prob- 
ably the most celebrated of this class was Marc Cazotte, otherwise known as 
" Pepin," who died in Paris in the last century at tlie age of sixty-two of a 
chronic intestinal disorder. He had no arms, legs, or scrotum, but from very 
jutting shoulders on each side were w^ell-formed hands. His abdomen ended 
in a flattened buttock with badly-formed feet attached. He was exhibited 
before the public and was celebrated for his dexterity. He performed nearly 
all the necessary actions, exhibited skilfulness in all his movements, and was 
credited with the ability of coitus. He was quite intellectual, being able to 
write in several languages. His skeleton is preserved in the Mus^e Dupuy- 
tren (Fig. 106). Flachsland ^ speaks of a woman who three times had borne 
children witliout arms and legs. Hastings'^ describes a living child born 
without any traces of arms or legs (Fig. 107). Garlick s has seen a child 
with neither upper nor lower extremities. In place of them were short 
stumps three or four inches long, closely resembling the ordinar}^ stumps after 

a 224, 1870. b 302, iv., 148. c 401, vi., 142. <i 379, vi., 321. 

e Observat. patliolog. Auat., p. 44. f 776, 1826, ii., 39. g 656, 1849. 



amputation. The head, eliest, body, and male genitals were well formed, and 

the child survived. Hutchinson *'' reports the 
history of a child born without extremities, 
probably the result of intrauterine am})uta- 
tion. The flaps were healed at the deltoid 
insertion and just below the groin. Par4^ 
says he saw in Paris a man without arms, who 
by means of his head and neck could crack a 
whip or hold an axe. He ate by means of his 
feet, dealt and played cards, and threw dice 
with the same members, exhibiting such dex- 
terity that iinally his companions refused to 
play with him. He was proved to be a 
thief and a murderer and was finally lianged 
at Gueldres (Fig. 108). Pare also relates 
having seen a woman in Paris who sewed, 
embroidered, and did other things with her 
feet. Jansen'*'" speaks of a man in Spain, 
born without arms, who could use his feet as 
1/ ^v ^.;::;;'»^ -^^ ^1^^, ^S(M as most people use their arms. Schenck 

^ T\^ 4^__-^)v '^iitl IvOtichius give descriptions of armless 


Hulke ^ describes a child of four whose 
upper limbs were absent, a small dim])le only 
being in their place. He had free movement 
of the shoulders in every direction, and could grasp oljjects between his cheeks 
and his acromian process ; the prehensile power of the toes was Avell developed, 

Fig. 106. — "Pepin" (Musee Dupuytreii). 

Fig. 107.— Limbless child. 

as he could pick up a coin thrown to him. A monster of the same conforma- 

a 779^ 1853, 343. 'j 618, 1020. c 550, 1877. 65. 



tion was the celebrated painter, Ducornet (Fig. lOD), who was l^orn at Lille 

on the 10th of January, 1806. He was completely deprived of arms, but the 

rest of the bod}' was well formed with 

the exception of the feet, of which the 

second toe was faulty. The deformity 

of the feet, however, had the happiest 

result, as the space between the great 

toe and its neighbor was much larger 

than ordinary and the toes much more 

mobile. He became so skilful in his 

adopted profession that he finally painted 

a picture eleven feet in height (repre- 
senting Mary Magdalene at the feet of 

Christ after the resurrection), which was 

purchased by the Government and given 

to the city of Lille. Broca describes 

James Leedgwood, who was de})rived of 

his arms and had only one leg. He ex- 
hibited great dexterity with his single 

foot, wrote, discharged a pistol, etc. ; he 

was said to have been able to pick up a 

sewing-needle on a slippery surface with 

his eyes blindfolded. Capitan described 

to the Societe d'anthro})ologie de Paris a 

young man without arms, who was said 

to play a violin and cornet with his feet. He was able to take a kerchief 
from his pocket and to blow his nose ; he could make a 
cigarette, light it, and put it in his mouth, play cards, 
drink from a glass, and eat with a fork by the aid of 
his dexterous toes. There was a creature exhibited some 
time since in the principal cities of France, who was called 
the " I'honune tronc." He was totally deprived of all his 
members. Curran ^ describes a Hindoo, a prostitute of 
forty, with congenital absence of both upper extremities. 
A slight fleshy protuberance depended from the cicatrix 
of the humerus and shoulder-joint of the left side, and 
until the age of ten there was one on the right side. She 
performed many tricks \yith her toes (Fig. 110). Caldani 
speaks of a monster without arms, Davis ^ mentions one, 
and Smith ^ describes a boy of four with his upper limbs 
Breschet has seen a child of nine with only portions of the 

upper arms and deformity of lower extremities and pelvis 
a 536, 1887, i., 116. ^ 530, 1885, 338. c 767, 1873, 89. 

Fig. 109.— Csesar 

entirelv absent. 

Par6 ^ says that 
d 618, 1018. 



Fig. 110. — >Hiiidoo armless 
woman (furran). 

he saw in Paris in 1573, at the gate of St. Andrew des Arts, a boy of nine, 

a native of a small village near Guise, who had no legs and whose left foot 

was represented by a fleshy body hanging from the 
ti'unk ; he had but two fingers hanging on his right 
hand, and had between his legs what resembled a 
virile penis. Pare attributes this anomaly to a de- 
fault in tlie (piantity of semen. 

The figure and skeleton of Harvey Leach, called 
"Hervio Xono," is in the museum of the University 
College in London. The pelvis was comparatively 
weak, the femurs hardly to be recognized, and the 
right tibia and foot defective ; the left foot was 
better developed, although far from being in due 
proportion to the trunk above. He was one of the 
most remarkable gymnasts of his day, and not- 
withstanding the distortion of his lower limbs had 
marvelous power and agility in them. As an arena- 
horseman, either standing or sitting, he was scarcely 
excelled. He walked and even ran quite well, and 
his power of leaping, partly with his feet and partly 
with his hands, was unusual. His lower limbs 
were so short that, erect, he touched the floor with 

his fingers, but he earned his livelihood as much with his lower as with his 

upper limbs. In his skeleton his left lower limb, between the hip and heel, 

measured 16 inches, while the right, between the 

same points, measured nine inches (Fig. 111)." 

Hare ^ mentions a boy of five and a half whose head 

and trunk were the same as in any other child of like 

age. He was 22|^ inches high, had no spinal curva- 
ture, but was absolutely devoid of lower extremities. 

The right arm was two inches long and the left 2^. 

Each contained the head and a small adjoining por- 
tion of the humerus. The legs were represented b}' 

masses of cellular tissue and fat covered by skin 

which projected about an inch. He was intelligent, 

had a good memor}^, and exhibited considerable 

activity. He seemed to have had more than usual 

mobility and power of flexion of the lower luml)ar 

region. AVheii on his back he was unable to rise 

up, but resting on the lower part of the pelvis he 

was able to maintain himself erect. He usually picked up objects with his 

teeth, and could hold a coin in the axilla as he rolled from place to place. 
a 476, 1864, ii., 60. b 779, 1858-9, x., 308. 

Fig. 111.— liar 




His rolling was accomplished by a peculiar twisting of the thorax and bend- 
ing of the pelvis. There was no history of maternal impression during preg- 
nancy, no injury, and no hereditary disposition to anomalous members. 
Figure 112 represents a boy with congenital deficiency of the lower extremi- 
ties, who was exhibited a few years ago in Philadelphia. In Figure 113, 
which represents a similar case in a girl whose photograph is deposited in the 
Mutter Museum of the College of Physicians, Philadelpliia, we see how cleverly 
the congenital defect may be remedied by mechanical contrivance. With her 
crutches and artificial legs this girl was said to have moved about easily. 

Parvin" describes a "turtle-man" as an ectromelian, almost entering the 
class of phocomelians or seal-like 
monsters ; the former term sig- 
nifies abortive or imperfect for- 
mation of the members. The 
hands and feet were normally de- 
veloped, but the arms, forearms, 
and legs are much shortened (see 
page 84). 

The " turtle-w^oman " of 
Demerara^ (Fig. 114) was so 
called because her mother wlien 
pregnant Avas frightened by a 
turtle, and also from the child's 
fancied resemblance to a turtle. 
The femur was six inches long ; 
the woman had a foot of six 
bones, four being toes, viz., the 
first and second phalanges of the 
first and second toes. She liad 
an acetabulum, capsule, and liga- 
mentum teres, but no tibia or 
fibula ; she also had a defective 
right forearm. She was never 

the victim of rachitis or like disease, but died of syphilis in the Colonial 
Hospital. In her twenty-second year she was delivered of a full-grown child 
free of deformity. 

There Avas a woman living in Bavaria, under the ()l)servation of Buhl, '-' 
who had congenital absence of both femurs and both fibulas. Almost all the 
muscles of the thigh existed, and the main attachment to the pelvis Avas by 
a large capsular articulation. Charpentier gives the portrait of a woman in 
whom there was a uniform diminution in the size of the limbs. Deboiit 
portrays a young man with almost complete absence of the thigh and leg, 

a International Med. Mag., Phila., June, 1892. b 476, 1807, ii., 578. c 368, 1861, No. 48. 

Fig. 112.— Congenital deficiency of the lower extremities. 



Vi'ii.. 11:;.— ('ongeiiital deficiuiicy of the lower extremities with remedial apparatus. 

Fig. 114. — The '' turtle-wuiiiaii.'' 

Fig. 115. — DflVutive Jevflupment 
of the right leg (Debout). 



from whose right hip tliere depended a foot (Fig. 115). Accrell " describes 
a peasant of twentv-six, born without a hip, thigli, or leg on the right side.' 
The external genital organs were in their usual place, but there was only one 
testicle in the scrotiun. The man was virile. The rectum instead of open- 
ing outward and underneath was deflected to the right. 

Supernumerary Limbs. — Haller reports several cases of supernumerary 
extremities. Plancus'' speaks of an infant M'ith a complete third leg, and 
Dumeril'= cites a similar instance. Geoifroy-Saint-Hilaire presented to the 
Academic des Sciences in 1<S30 a child with four legs and feet who was in 
good health. Amman saw a girl with a large thigli attached to her nates. 
Below the thigh was a single leg made by the fusion of tsvo legs. No patella 
was found and the knee was anchylosed. One of the feet of the supernu- 

Fig. llfi. — Gustav Evrard (after Guerin). 

Fig. 117. — Eight-limbed monster (after Pare). 

merary limb had six toes, while the other, which was merely an outgrowth, 
had two toes on it. 

According to Jules Guerin, the child named Gustav Evrard was born 
with a thigh ending in two legs and two imperfect feet depending from the 
left nates (Fig. 116). 

Tucker '-^ describes a baby born in the Sloane Maternity in Ncav York, 
October 1, 1894, who had a third leg hanging from a bony and fleshy union 
attached to the dorsal spine. The supernumerary leg was Avell formed and 
had a left foot attached to it. I^arkin and Jones ^ mention the removal of a 
meningocele and a supernumerary limb from an infant of four months. Tiiis 

a Med. Chirurg., Anat. Cases, Loudou, 1758, 8°. ^ De niou.^tris, etc., Venetiis, 1749. 
c Bull, de la Si)C. philoni., iii., 3. d 123^ j^m.^ 1895. e 224, 1889, ii., 310. 



limb containefl tliroo finojors only, one of which did not have a bony 

Pare ^ says that on the day the Venetians and the Genevois made- peace 
a monster was l)orn in Italy which had four legs of equal proportions, and 
besides had two supernumerary arms from the elbows of the normal limbs. 
This creature lived and was baptized (Fig. 117). 

Anomalies of the Feet. — Hatte'' has seen a woman who bore a child 
that had three feet. l>ull '-■ gives a description of a female infant with the 
left foot double or cloveu. There was only one heel, but the anterior portion 
consisted of an anterior and a pos- 
terior part. The anterior foot pre- 
sented a great toe and four smaller 
ones, but deformed like an example 
of talipes equinovarus. Contin- 
uous with the outer edge of the 
anterior part and curving beneath 
it was a posterior part, looking not 
unlike a second foot, containing 

Fig. 118. — Double foot (Bull). 

Fig. 119. — Examples of "Sirens," showing fusion of the 
lower extremities. 

six well-formed toes situated directly beneath the other live. The eleven 
toes were all perfect and none of them were webbed (Fig. 118). 

There is a class of monsters called " Sirens " on account of their resem- 
blance to the fabulous creatures of mythology of that name__. Under the 
inlluence of compression exercised in the uterus during the early jjeriod of 
gestation fusion of the inferior extremities is eifected. Tiie acconqjanying 
illustration shows the appearance of these monsters (Fig. 11''), which are 
thought to resemble the enchantresses celebrated by Homer. 

Anomalies of the Hand. — Blumenbach speaks of an officer who, having 

a 618, 1017. l> 462, T. ii., 229. c 218, 1S75, xciii., 1293. 



lost his right hand, was subsequently presented bv his Avife with infants of 
both sexes showing the same deformity. ]Murray " cites the instance of a' 
Avomau of thii'ty-eiglit, well developed, healthy, and the mother of normal 
children, who had a double 
hand. The left arm was ab- 
normal, the flexion of the elbow 
imperfect, and the forearm ter- 
minated in a doul)le hand with 
only rudimentary thumbs. In 
working as a charwoman she 
leaned on the back of the 
flexed carpus. The d()ul)le hand 
could grasp firmly, though the 
maximum power was not so 
great as that of the right hand. 
Sensation was equally acute in 
all three of the hands. The 
middle and ring fingers of the 
supernumerary hand were web- 
bed as far as the proximal joints, 
and the movements of this hand 
were stiif and imperfect. No 
single finger of the two hands 
could be extended while the 

other seven were flexed (Fig. 120). Giraldes saw an infant in 18(34 with 
somewhat the same deformity, but in which the disposition of the muscles 
and tendons permitted the ordinary movements (Fig. 121). 

AL)sence of Digits. — ^laygrier'' describes a woman of twenty-four who 
instead of having a hand on each arm had only one finger, 
and each foot had but two toes. She was delivered of two 
female children in 1827 and one in 1829, each having 
exactly the same deformities. Her mother was perfectly 
formed, l)ut the father had l)ut one toe on his foot and 
one finger on his left hand. 

Kohler '' gives photographs of quite a remarkable case 
of suppression and deformity of the digits of both the 
fingers and toes (Fig. 122). ^ 

Figure 123 shows a man who was recently exhibited 
in Philadelphia. He had but two fingers on each hand and two toes on each 
foot, and resembles Kohler's case in the anomalous digital conformation. 

Figure 124 represents an exhibitionist with congenital suppression of four 
digits on each hand. 

120. — Double IkukJ (Murray). 

Fig. 121.— Double hand 

a 650, 1861-4, iv., 163 ; also 550, xlvi. 

^ Essai siir les monstres linmaines, Diss Inaug. 

c 199, March 6, 1893. 



Fig. 122. — .Suppression and deformity 
of digits (Kohler). 

Fig. 12.3. — .•Suppression of digit-s. 

Fig. 124. — Suppi-e.-^sion ol digits 


Tubby '^ has seen a boy of three in whom the first, second, and third toes 
of each foot were suppressed, the great toe and the little toe being so over- 
grown that they could be opposed. In this family for four generations 15 indi- 
viduals out of 22 presented this defect of the lower extremity. The patient's 
brothers and a sister had exactly the same deformity, which has been called 
" lobster-claw foot." 

Falla of Jedburgh speaks of an infant who was born without forearms 
or hands ; at the elbow there was a single finger attached by a thin string of 
tissue. This was the sixth child, and it presented no other deformity. Falla 
also says that instances of intrauterine digital amputation are occasionally 

According to Annandale, supernumerary digits may be classified as 
follows : — 

(1) A deficient organ, loosely attached by a narrow pedicle to the hand 
or foot (or to another digit). , 

(2) A more or less developed organ, free at its extremity, and articu- 
lating with the head or sides of a metacarpal, metatarsal, or phalangeal bone. 

(3) A fully developed separate digit. 

(4) A digit intimately united along its Avhole length with another digit, 
and having either an additional metacarpal or metatarsal bone of its own, or 
articulating witli the head of one which is common to it and another digit. 

Superstitions relative to supernumerary fingers have long been prevalent. 
In the days of the ancient Chaldeans it was for those of royal birth especially 
that divinations relative to extra digits were cast. Among the ancients we 
also occasionally see illustrations emblematic of wisdom in an individual with 
many fingers, or rather double hands, on each arm. 

Hutchinson,'^ in his comments on a short-limbed, polydactylous dwarf 
(Fig. 125) which was dissected by Ruysch, the celebrated Amsterdam anat- 
omist, writes as follows : — 

" This quaint figure is copied from Theodore Kerckring's ' Spici- 
legium Anatomicum,' published in Amsterdam in 1670. The description 
states that the body was that of an infant found drowned in the river on 
October 16, 1668. It was dissected by the renowned Ruysch. A detailed 
description of the skeleton is given. ]My reason for now reproducing the 
plate is that it offers an important item of evidence in reference to the develop- 
ment of short-liml)ed dwarfs. Although we must not place too much reliance 
on the accuracy of the draughtsman, since he has figured some superfluous 
lumbar vertebrse, yet there can be no doubt that the limbs are much too 
short for the trunk and head. This remark especially applies to the lower 
limbs and pelvis. These are exactly like those of the Norwich dwarf and 
of the skeleton in the Heidelberg Museum which I described in a recent 
number of the ' Archives.' The point of extreme interest in the present case 

a 476, Feb. 17, 1894. b 166, April, 1893. 




is that this dwarfing of the limbs is associated witli polydactylism. Both the 
hands have seven digits. Tlie right foot lias eight and the left nine. The 
conditions are not exactly symmetrical, since in some instances a metacarpal or 

metatarsal bone is wanting ; or, to put it 
otherwise, two are welded together. It will 
be seen that the upper extremities are so 
short that the tips of the digits will only 
just touch the iliac crests. 

'* This occurrence of short limbs with 
polydactylism seems to prove conclusively 
that the condition may be due to a modi- 
fication of development of a totally different 
nature from rickets. It is probable that 
the infant was not at fidl term. Among 
the points which the author has noticed in 
his description are that the fontanelle w'as 
double its usual size ; that the orbits were 
somcAvhat deformed ; that the two halves 
of the lower jaw^ were already united ; and 
that the ribs were short and badly formed. 
He also, of course, draws attention to the 
shortness of the limbs, the stoutness of the 
long bones, and the supernumerary digits. 
I find no statement that the skeleton was 
deposited in any nuiseum, but it is very pos- 
sible that it is still in existence in Amster- 
dam, and if so it is Yevy desirable that it should be more exactly described." 
In Figure 126, A represents division of thumb after Guyot-Daubes, 
B shows a typical case of , 

supernumerary fingers, / ._^ \ \ 

and C pictures Morand's 
case of duplication of 
several toes. 

Forster gives a sketch 
of a hand wath nine fin- 
gers and a foot wdth nine 
toes. Voight records an 
instance of 13 fingers on 
■each hand and 1 2 toes on 
■each foot. Saviard saw 
an infant at the Hotel-Dieu in Paris in 1(387 which had 40 digits, ten on 
each member. Annandale relates the history of a woman who had six fingers 
and two thumbs on each hand, and another who had eight toes on one foot. 

Fig. 125. — Skeleton of a short-limbed, 
polydactylous dwarf. 

Fig. 126. — Supernumerary fingers and toes. 


Meckel tells of a case in which a man had 12 finoers and 12 toes, all well 
formed, and whose children and grandchildren inherited the deformity. 
Mason ^ has seen nine toes on the left foot. There is recorded ^ the account 
of a child who had 12 toes and six lingers on each hand, one fractured. 
Braid ^ describes talipes varus in a child of a few months who had ten toes. 
There is also on record '^ a collection of cases of from seven to ten fingers on 
each hand and from seven to ten toes on each foot. Scherer •* gives an illus- 
tration of a female infant, otherwise normally formed, with seven fingers on 
each hand, all united and bearing claw-like nails. On each foot there was 
a double halux and five other digits, some of which were webbed. 

The influence of heredity on this anomaly is well demonstrated. Reau- 
mur was one of the first to prove this, as shown by the Kelleia family of 
Malta, and there have been many corroboratory instances reported ; it is 
shown to last for three, four, and even five generations ; intermarriage with 
normal persons finally eradicates it. 

It is particularly in places where consanguineous marriages are prevalent 
that supernumerary digits persist in a family. The family of Foldi in the 
tribe of Hyabites living in Arabia are very numerous and confine their 
marriages to their tribe. They all have 24 digits, and infants born with the 
normal number are sacrificed as being the offspring of adultery. The inhab- 
itants of the village of Eycaux in France, at the end of the last century, 
had nearlv all supernumerary digits either on the hands or feet. Being 
isolated in an inaccessible and mountainous region, they had for many years 
intermarried and thus perpetuated the anomaly. Communication being opened, 
thev emigrated or married strangers and the sexdigitism vanished. Mauper- 
tuis recalls the history of a family living in Berlin whose members had 24 
digits for many generations. One of them being presented with a normal 
infant refused to acknowledge it. There is an instance in the Western 
United States'' in which supernumerary digits have lasted through five 
generations. Cameron s speaks of two children in the same family who 
were polydactylic, though not having the same number of supernumerary 

Smith and Xorwell '^ report the case of a boy of fifteen both of whose 
hands showed webbing of the middle and ring fingers and accessory nodules 
of bone between the metacarpals, and six toes on each foot. The boy's father 
showed similar malformations, and in five generations 21 out of 28 individ- 
uals were thus malformed, ten females and 1 1 males. The deformity was 
especially transmitted in the female line. 

Instances of supernumerary thumbs are cited by Panaroli,' Ephem- 
orides, Munconys, as well as in numerous journals since. This anomaly is 

^ 705, 1879, n. s.^ ix., 37-42. ^ 475, 1832, ii., 673. c 225, 1848. ;., 339. 

•i 562, 1870. e Arohiv f. Kiuderheilk., xvii., 1894, 244. f 130, No. 16. 

g Montreal Med. Jour., Dec, 1894. ^ 224, July 7, 1894. » 617, iii., obs. 48. 



not confined to man alone ; apes, clogs, and other lower animals possess it. 
Bucephalus, the celebrated horse of Alexander, and the horse of Caesar were 
said to have been cloven-hoofed. 

Hypertrophy of the digits is the result of many diiferent processes, 
and true hyjjcrtrophy or gigantism must be diiferentiated from acromegaly, 
elephantiasis, leontiasis, and arthritis deformans, for which distinction the 
reader is referred to an article l)y Park.'' Park also calls attention to the 
difference between acquired gigantism, particularly of the finger and toes, and 
another condition of congenital gigantism, in which either after or before 
birth there is a relatively disproportionate, sometimes enormous, overgrowth 
of perhaps one finger or two, perhaps of a limited portion of a hand or foot, 
or possibly of a part of one of the limbs. The best collection of this kind 

of specimens is in the College of Sur- 
geons in London. 

Curling*^ quotes a most peculiar 
instance of hypertrophy of the fingers 
in a sickly girl (Fig. 127). The mid- 
dle and ring fingers of the right hand 
were of unusual size, the middle fin- 
ger measuring 5^ inches in length and 
fi)ur inches in circumference. ( )n the 
left hand the thumb and middle fin- 
gers were hypertrophied and the in- 
dex finger was as long as the middle 
one of the right hand. The middle 
finger had a lateral curvature out- 
ward, due to a displacement of the 
extensor tendon. This affection re- 
sembled acromegaly. Curling cites 
similar cases, one in a Spanish gentle- 
man. Governor of Luzon, in the Philippine Islands, in 1850, who had an 
extraordinary middle finger, which he concealed l>y carrying it in the breast 
of his coat. 

Hutchinson ''^^ exhibited a photograph showing the absence of the 
radius and thumb, w^ith shortening of the forearm. Conditions more or less 
approaching this had occurred in several members of the same family. In 
some they were associated with defects of development in the lower extremi- 
ties also. 

The varieties of club-foot — talipes varus, valgus, equinns, equino-varus, 

etc. — are so well known that tliey will be passed with mention only of a few 

persons who have been noted for their activity despite their deformity. 

Tyrtee, Parini, Byron, and Scott are among the poets who were club-footed; 

a Inter. Med. Mag., Pliila., July, 1895. b 550. 1845, xxviii., G23. 

Fig. 127. — Hypertrophied fingers. 


some writers say that Shakespeare suffered in a slight degree from this de- 
formity. Agesilas, Genserie, Robert II., Duke of Normandy, Henry II.', 
Emperor of the West, Otto II., Duke of Brunswick, Charles II., King of 
Naples, and Tamerlane were victims of deformed feet. JNIlle. Yalliere, the 
mistress of Louis XIV., was supposed to have both club-foot and hip-disease. 
Genu valgum and genu varum are ordinary deformities and quite common 
in all classes. 

Transpositions of the character of the vertebrae are sometimes seen. 
In man the lumbar vertebra? have sometimes assumed the character of the 
sacral vertebrse, the sacral vertebrae presenting the aspect of lumbar vertebrse, 
etc. It is quite common to see the first lumbar vertebra presenting certain 
characteristics of the dorsal. 

Numerical anomalies of the vertebrae are quite common, generally 
in the lumbar and dorsal regions, being quite rare in the cervical, although 
there have been instances of six or eight cervical vertebrse. In the lower 
animals the vertebrse are prolonged into a tail, which, however, is sometimes 
absent, particularly when hereditary influence exists. It has been noticed 
in the class of dogs whose tails are habitually amputated to improve their 
appearance that the tail gradually decreases in length. Some breeders deny 
this fact. 

Human Tails. — The })rolongation of the coccyx sometimes takes the shape 
of a caudal extremity in man. Broca and others claim that the sacrum and 
the coccyx represent the normal tail of man, but examples are not infrequent 
in which there has l^cen a fleshy or bony tail appended to the coccygeal 
region. Traditions of tailed men are old and widespread, and tailed races 
were supposed to reside in almost every country. There was at one time 
an ancient belief that all Cornishmen had tails, and certain men of Kent 
were said to have been afflicted with tails in retribution for their insults to 
Thomas a Becket. Struys, a Dutch traveler in Formosa in the seventeenth 
century, describes a wild man caught and tied for execution who had a tail 
more than a foot long, which was covered with red hair like that of a cow. 

The Niani Niams of Central Africa are reported to have tails smooth and 
hairy and from two to ten inches long. Hubsch of Constantinople remarks 
that both men and women of this tribe have tails. Carpus, or Berengarius 
Carpensis, as he is called, in one of his Commentaries said that there 
were some people in Hibernia with long tails, but whether they were fleshy 
or cartilaginous could not be known, as the people could not be approached. 
Certain supposed tailed races which have been described by sea-captains and 
voyagers are really only examples of people who wear artificial appendages 
about the waists, such as palm-leaves and hair. A certain Wesleyan mission- 
ary, George Brown, in 1876 spoke of a formal l)reeding of a tailed race in 
Kali, off the coast of New Britain. Tailless children were slain at once, as 
they would be exposed to public ridicule. The tailed men of Borneo are 



people afflicted with hereditary nial formation analogous to sexdigitism. A 
tailed race of princes have ruled Kajoopootana, and are fond of their ances- 
tral mark.^-^^ There are fabulous stories told of canoes in the East Indies 
which have holes in their benches made for the tails of the rowers. At one 
time in the East the presence of tails was taken as a sign of brute force. 

There was reported from Caracas '"* the discovery of a tribe of Indians in 
Paraguay who were provided wilh tails. The narrative reads somewhat after 
this manner : One day a numl)er of workmen belonging to Tacura Tuyn while 
engaged in cutting grass had their mules attacked by some Guayacuyan In- 
dians. The workmen pursued the Indians but only succeeded in capturing a 
boy of eight. He was taken to the house of Seiior Francisco Galeochoa, at 
Posedas, and was there discovered to have a tail ten inches long. On inter- 
rogation the boy stated that he had a brother who had a tail as long as his 
own, and that all the tribe had tails. 

Aetius, Bartholinus, Falk, Harvey, Kolping, Hesse, Paulinus, Strauss, and 
^. Wolff give descriptions of tails. Blanchard -^^ 

says he saw a tail fully a span in length ; and 
there is a description in 1690 of a man by 
the name of Emanuel Konig, a son of a doctor 
of laws,^'*^ who had a tail half a span long, 
which grew directly downward from the coccyx 
and was coiled on the perineum, causing much 
discomfort. Jacob'' describes a pouch of skin 
resembling a tail which hung from the tip of 
the coccyx to the length of six inches. It Avas 
removed and was found to be thicker than the 
thumb, consisted of distinctly jointed portions 
with synovial capsules. Gosselin saw at his 
clinic a caudal appendix in an infant which measured about ten cm. (Fig. 128). 
Lissner says that in 1872 he assisted in the deliveiy of a young girl who had 
a tail consisting c»f a coccyx prolonged and covered with skin, and in 1884 he 
saw the same girl, at this time tlie tail measuring nearly 13 cm. 

Virchow received for examination a tail three inches long amputated from 
a boy of eight weeks. Ornstein, chief physician of the Greek army, descrilies 
a Greek of twenty-six who had a hairless, conical tail, free only at the tip, 
two inches long and containing three vertebne. He also remarks that other 
instances have been oljserved in recruits. Thirk of Broussi\ in 1820 de- 
scribed the tail of a Kurd of twenty-two which contained four vertebrae. 
Belinovski ^ gives an account of a hip-joint amputation and extirpation of a 
fatty caudal extremity, the only one he had ever observed. 

Before the Berlin Anthropological Society there were presented two adult 
male Papuans, in good health and spirits, who had been brought from New 
a 4T6, 1885, ii., 452. >> 311, 1827. c 070^ 1892. 

Fig. 128. — Caudal appendix observed iu a 
cliiid in the clinic of M. Gosselin. 


Guinea ; their coccygeal bones projected 1^ inches. Oliver Wendell Holmes 
in the Atlantic Monthly, June, 1890, says that he saw in London a photo- 
graph of a boy with a consideral)le tail. The " Moi Boy " was a lad of 
twelve, who was found in Cochin China, with a tail a foot long which was 
simply a mass of flesh. Miller * tells of a West Point student who had an 
elongation of the coccyx, forming a protuberance which bulged very visibly 
under the skin. Exercise at the riding school always gave him great dis- 
tress, and the protuberance would often chafe until the skin was broken, the 
blood trickling into his boots. 

Bartels'^ presents a very complete article in which he describes 21 per- 
sons born with tails, most of the tails Ijeing merely fleshy protuberances. 
Darwin -^^ speaks of a person with a fleshy tail and refers to a French arti- 
cle on human tails. ° 

Science ^ contains a description of a negro child born near Louisville, 
eight weeks old, with a pedunculated tail 2^ inches long, with a base 1^ 
inches in circumference. The tail resembled in shape a pig's tail and had 
grown \ inch since birth. It showed no signs of cartilage or bone, and had 
its origin from a point slightly to the left of the median line and about an 
inch above the end of the spinal column. 

Dickinson'' recently reported the birth of a child with a tail (Fig. 129). 
It was a well-developed female between b^ and six pounds in weight. The 
coccyx was covered with the skin on both the anterior and posterior surfaces. 
It thus formed a tail of the size of the nail of the little finger, with a length 
of nearly y^ inch on the inner surface and | inch on the rear surface. This 
little tip could lie raised from the body and it slowly sank back. 

In addition to the familiar caudal projection of the human fetus, Dickin- 
son mentions a group of other vestigial remains of a former state of things. 
Briefly these are : — 

(1) The plica semilunaris as a vestige of the nictitating membrane of 
certain birds. 

(2) The pointed ear, or the turned-down tip of the ears of many men. 

(3) The atrophied muscles, such as those that move the ear, that are well 
developed in certain people, or that shift the scalp, resembling the action of 
a horse in ridding itself of flies. 

(4) The supracondyloid foramen of the humerus. 

(5) The vermiform appendix. 

(6) The location and direction of the hair on the trunk and limbs. 

(7) The dwindling wisdom-teeth. 

(8) The feet of the fetus strongly deflected inward, as in the apes, and 
persisting in the early months of life, together with great mobility and a dis- 
tinct projection of the great toe at an angle from the side of the foot. 

a 545, 1881, 165. b 157, 1880. <= 669, 1867-8, p. 625. 

d 727, June 6, 1884. e 227, viii. , 568, 1894. 



(9) The remarkable grasping power of the hand at birth and for a few 
weeks thereafter, that permits young babies to suspend their whole weight on 
a cane for a period varying from half a minute to two minutes. 

Horrocks ^ ascribes to these anal tags a pathologic importance. He claims 
that they may be productive of fistula in ano, su])erficial ulcerations, fecal con- 
cretions, fissure in ano, and that they may hypertrophy and set up tenesmus 
and other troubles. The presence of human tails has given rise to discussion 
between friends and opponents of the Darwinian theory. By some it is 

Fig. 129. — Skin-covered coccyx fonuing a rudimentary tail in a female child at birth: C, coccyx; A, anus 


considered a reversion to the lower species, while others deny this and claim 
it to be simply a pathologic appendix. 

Anomalies of the Spinal Canal and Contents. — When there is a 
default in the spinal column, the vice of conformation is called spina bifida. 
This is of two classes : first, a simple opening in the vertebral canal, and, 
second, a large cleft sufficient to allow the egress of spinal membranes and 
substance. Figure 130 represents a large congenital sacral tumor. 

Achard'^ speaks of partial duplication of the central canal of the spinal 
cord. De Cecco ^ reports a singular case of duplication of the lumbar seg- 

a Quar. Med. Jour., July, 1894. b 242, 1888, 922. c Morgagui, Napoli, 1857, i., 307. 



Fig. 130. -Sacral tu- 
mor (Mutter Mus., Col. 
of Phys.). 

meiit of the spinal cord. AVagner speaks of duplication of a portion of the 

spinal cord. 

Foot '' records a case of amyelia, or absence of the spinal cord, in a fetus 

with hernia cerebri and complete fissure of the spinal 

column. Nicoll and Arnold '' describe an anencephalous 

fetus with absence of spinal marrow ; and Smith also 

records the birth of an amyelitic fetus. "^ 

In some persons there are exaggerated curvatures 

of the spine. The first of these curvatures is called 

kyphosis, in which the curvature is posterior ; second, lor- 
dosis, in which the curvature is anterior ; third, scoliosis, 

in which it is lateral, to the right or left. 

Kyphosis is the most common of the deviations in man 

and is most often found in the dorsal region, although it 

may be in the lumbar region. Congenital kyphosis is very 

rare in man, is generally seen in monsters, and when it does 
exist is usually accompanied hj lordosis 
or spina bifida. We sometimes observe a condition of 
anterior curvature of the lumbar and sacral regions, which 
might be taken for a congenital lordosis, but this is really a 
deformity produced after birth by the physiologic weight 
of the body. Figure 131 represents a case of lordosis caused 
by paralysis of the spinal muscles. 

Analogous to this is what the accoucheurs call spondy- 
lolisthesis. Scoliosis may be a cervicodorsal, dorso- 
lunibar, or lumbosacral curve, and the inclination of the 
vertebral column may be to the right or left (Figs. 132 
and 133). The pathologists divide scoliosis into a myo- 
})athic variety, in which the trouble is a physiologic an- 
tagonism of the muscles ; or osteopathic, ordinarily asso- 
ciated with rachitis, which latter variety is generally 
accountable for congenital scoliosis. In some cases the 
diameter of the chest is shortened to an almost incredible 
degree, but may yet be compatible with life. Glover '^ speaks 
of an extraordinary deformity of the chest Avitli lateral 
curvature of the spine, in which the diameter from the 
pit of the stomach to the spinal integuriient was only 5| 

Supernumerary ribs are not at all uncommon in 
man, nearly every medical museum having some examples. 

Cervical ribs are not rare. Gordon '^ describes a voung man of seventeen 

Fig. 131. — Lordosis, 
— paralysis of spinal 
muscle (Hirst). 

a 536, Dublin, 1865, xi., 435. 
fi476, 1857, i., 263. 

bl24, xxii., 253. 

c 476, 1848, ii., 400. 
e 355, Oct. 15, 1894. 



in whom there was a pair of siipcrnumerarv ribs attached to the cervical 
vertebrte. Bernhardt " mentions an instance in which cervical ribs caused 
motor and sensory disturbances. Dumerin of Lyons showed an infant of 
eight days which had an arrested development of the 2d, 3d, 4th, and otli 
ribs. Cases of deficient ribs are occasionally met. AA istar in 1818 gives 
an account of a person in whom one side of the thorax was at rest while the 
other performed the movements of breathing in the usual manner. 

In some cases we see fissure of the sternum, caused either by deficient 
union or absence of one of its constituent parts. In the most exaggerated 
cases these fissures permit the exit of the heart, and as a general rule ecto- 

Fig. 132.— Non-rachitic scoliosis (Charpeutier). Fig. 133.— Same woman, back view (Charpeutier). 

pies of the heart are thus caused. Pavy ^ has given a most remarkable case 
of sternal fissure in a young man of twenty-five, a native of Hamlnirg. He 
exhibited himself in one medical clinic after another all over Europe, and 
was always viewed with the greatest interest. In the median line, corre- 
s])onding to the absence of sternum, was a longitudinal groove l)ounded on 
either side by a continuous hard ridge which articulated with the costal carti- 
lages. The skin passed naturally over the chest from one side to another, 
but was raised at one part of the groove by a pulsatile swelling M'hich occu- 
pied the position of the right auricle. The clavicle and the two margins of 
the sternum had no connections whatever, and below the groove was a hard 
a 199, 1894. b 548, 1857, ii., 522. 



substance corresponding to the ensiform cartilage, which, however, was very- 
elastic, and allowed the patient, under the influence of the pectoral muscles, 
when the upper extremity was fixed, to open the groove to nearly the extent 
of three inches, which was more than twice its natural width. By approxi- 
mating his arms he made the ends of his clavicles overlap. AVhen he coughed, 
the right lung suddenly protruded from the chest through the groove and 
ascended a considerable distance above the clavicle into the neck. Between 
the clavicles another pulsatile swelling was easily felt but hardly seen, which 
was doubtless the arch of the aorta, as by putting the fingers on it one could 
feel a double shock, synchronous with distention and recoil of a vessel or 
opening and closing of the semilunar valves. 

Madden * pictures (Figs. 134 and 135) a Swede of forty witli congenital 

Fig. 134.— Congenital fissure of sternum 

Fig. 135. — Congenital fissure of the sternum. 

absence of osseous structure in the middle line of the sternum, leaving a fis- 
sure 5|- X If X 2 inches, the longest diameter being vertical. Madden also 
mentions several analogous instances on record. Groux's case was in a person 
of forty-five, and the fissure had the vertical length of four inches. Hodgeu ^ 
of St. Louis reports a case in which there was exstrophy of the heart through 
the fissure. Slocum ° reports the occurrence of a sternal fissure 3x1^ inches 
in an Irishman of twenty-five. ]\Iadden also cites the case of Abbott in an 
adult negress and a mother. Obermeier mentions several cases.*^ Gibson 
and ]\Ialet ^ describe a presternal fissure uncovering the base of the heart. 
Ziemssen, Wranv, and AMlliams also record congenital fissures of the sternum. 

a 597, 1885, 406. 
diei, 1869, xlvi., 209. 

b 133, Oct., 1878. 

c 768, 1860, iii., 310. 
e 451, xiv., 1. 


Thomson^ has collected 86 cases of thoracic defects and summarizes his 
paper by saying that the structures deticient are generally the hair in the 
mammary and axillary regions, the subcutaneous fat over the muscles, nip- 
ples, and breasts, the pectorals and adjacent muscles, the costal cartilages 
and anterior ends of ribs, the hand and forearm ; he also adds that there 
may be a hernia of the lung, not hereditary, but probably due to the pressure 
of the arm against the chest. De Marque ^*^^ gives a curious instance in which 
the chin and chest were congenitally fastened together. jNIuirhead'^ cites an 
instance in which a firm, broad strip of cartilage resembling sternomastoid 
extended from below the left ear to the left upper corner of the sternum, 
being entirely separate from the jaw. 

Some preliminary knowledge of embryology is essential to understand the 
formation of branchial fissures, and we refer the reader to any of the 
standard works ou embryology for this information. Dzondi was one of the 
first to recognize and classify congenital fistulas of the neck. The proper 
classification is into lateral and median fissures. In a case studied by Fev- 
rier'' the exploration of a lateral pharyngeal fistula produced by the intro- 
duction of the sound violent reflex phenomena, such as pallor of the face 
and irregular, violent beating of the heart. The rarest of tlie lateral class is 
the preauricular fissure, which has been observed by Fevrier, Le Dentu, 
Marchand, Peyrot, and Routier. 

The median congenital fissures of the neck are probably caused by defec- 
tive union of the branchial arches, although Arndt thinks that he sees in 
these median fistulas a persistence of the hypobranchial furrow Avhich exists 
normally in the aniphioxus. They are less frequent than the preceding 

The most typical form of malformation of the esophagus is imperfora- 
tion or obliteration. Van Cuyck of Brussels in 1824 delivered a child 
wdiich died on the third day from malnutrition. Postmortem it m as found 
that the inferior extremity of the esophagus to the extent of about two inches 
was converted into a ligamentous cord. Porro ^ describes a case of con- 
genital obliteration of the esophagus which ended in a cecal pouch about one 
inch below the inferior portion of the glottidean aperture and from this 
point to the stomach onl}^ measured an inch ; there was also tracheal com- 
munication. The child was noticed to take to the breast w'ith avidity, but 
after a little suckling it would cough, become livid, and reject most of the 
milk through the nose, in this way almost suifocating at each^ paroxysm ; it 
died on the tliird day. 

In some cases the esophagus is divided, one portion opening into the 
bronchial or other thoracic organs. Brentano'' describes an infant dying 
ten days after birth whose esophagus w'as divided into two portions, one 

a 759, Jan., 1855. b 224, 1887, 177. 

c Societe de Chirurgie, 1892. d 151^ i871. e 242, 1894. 



terminating in a culdesac, the other opening into the bronchi ; the left kidney 
was also displaced downward. Blasius-'^ describes an anomalous case of 
dnplication of the esophagus. Grashuys, and subsequently Vicq d'Azir, 
saw a dilatation of the esophagus resembling the crop of a bird. 

Anomalies of the Lungs. — Carper describes a fetus of thirty-seven 
wrecks in whose thorax he found a ^'cry voluminous thymus gland but no 
lungs. These organs were simply represented by two little oval bodies hav- 
ing no lobes, with the color of the tissue of the liver. The heart had only 
one cavity but all the other organs were perfectly formed. This case seems 
to be unique. Tichomiroff '^ records the case of a woman of twenty- four 
who died of pneumonia in whom the left lung was entirely missing. No 
traces of a left bronchus existed. The subject was very poorly developed 
physically. Tichomirolf finds 
four other cases in literature, in 
all of which the left lung was 
absent. Theremin and Tyson 
record cases of the absence of 
the left lung. 

Supplementary pul mona rv 
lobes are occasionally seen in 
man and are taken by some 
authorities to be examples of 
retroo-ressive anomalies tendinc: 
to prove that the derivation of 
the human race is from the 
quadrupeds which show analo- 
gous pulmonary malformation. 
Eckley^ reports an instance of 
supernumerary lobe of the right 
lung in close connection with 
the vena azygos major (Fig. 

136). Collins ^ mentions a similar case. Bonnet and Edwards speak of 
instances of four lobes in the right huig. Testut and ^Nlarcondes '' report a 
description of a lung with six lobes. 

Anomalies of the Diaphragm. — Diemerbroeck is said to have dissected 
a human subject in wliom the diaphragm and mediastinum were apparently 
missing, but such cases must l)e very rare, although we frequently find marked 
deficiency of this organ. Bouchaud '' reports an instance of absence of the right 
half of the diaphragm in an infant born at term. Lawrence ^ mentions con- 
genital deficiency of the nuiscular fibers of the left half of the diaphragm with 

a Inter-Monatselir. f. Anat. u. Physiol., 1895. ''Chicago ]\I. Times, June, 1895. 

c 310, Iviii., 252. dGaz. hebcl. d. sc. med. de Bordeaux, 1880, i., 1045. 

e 242, .xx.xviii., 344. f 476, 1852, ii., 327. 

Fig 136. — Supeniiuuerary lung: 1, upper lobe of right 
lung; 2, middle or cuneate lobe; 3, lower lobe; 4, super- 
numerary lobe; 5, vena azygos major; 6, descending vena 
cava; 7, phrenic nerve (Eckley). 


displacement of tlie stomach. The patient died of double pneumonia. Car- 
ruthers, jMcCIintock, Polaillon, and van Geison also record instances of con- 
genital deficiency of part of the diaphragm. Recently Dittel^ reported unilateral 
defect in the diaphragm of an infant that died soon after birth. The stomach, 
small intestines, and part of the large omentum lay in the left pleural cavity ; 
both the phrenic nerves were normal. Many similar cases of diaphragmatic 
hernia have been observed. In such cases the opening may be large enough 
to allow a great part of the visceral constituents to pass into the thorax, 
sometimes seriously interfering with respiration and circulation by the 
pressure which ensues. Alderson'' reports a fatal case of diaphragmatic 
hernia with symptoms of jmeumothorax. The stomach, spleen, omentum, 
and transverse colon were found lying in the left pleura. Berchon ° mentions 
double perforation of the diaphragm with hernia of the epiplo5n. The most 
extensive paper on this subject was contributed by Bodwitch,'^ who, besides 
reporting an instance in the Massachusetts General Hospital, gives a 
numerical analysis of all the cases of this affection found recorded in the 
writings of medical authors between the years 1610 and 184(5. Hillier '^ 
speaks of an instance of congenital diaphragmatic hernia in which nearly all 
the small intestines and two-thirds of the large passed into the right side 
of the thorax. Macnab^ reports an instance in which three years after the 
cure of empyema the whole stomach constituted the hernia. Recently 
Joly ^ described a congenital hernia of the stomach in a man of thirty- 
seven, who died from collapse following lymphangitis, i)ersistcnt vomit- 
ing, and diarrhea. At the postmortem there was found a defect in the 
diaphragm on the left side, permitting herniation of the stomach and first 
part of the duodenum into the left pleural cavity. Thcn-e was no history of 
traumatism to account for strangulation. Longworth '^ cites an instance of 
inversion of the diaphragm in a human subject. Bartholinus ^ mentions 
coalition of the diaphragm and liver ; and similar eases are spoken of 
by ]\Iorgagni and the Ephemerides. Hotiman ^-^ describes diaphragmatic 
junction with the lung. 

Anomalies of the Stomach. — The Ephemerides contains the account of 
a dissection in which the stomach was found wanting, and also speaks of two 
instances of duplex stomach. Bartliolinus,'-'" Heister, Hufeland, Morgagni, 
Riolan, and SandifortJ cite exami)les of du})lex stomach. Bonet speaks of a 
case of vomiting which was caused by a double stomach. Struthers ^^ reports 
two cases in which there were two cavities to the stomach. Struthers also 
mentions that ]\Iorgagni, Home, Monro, Palmer, Larry, Blasius, Hufeland, 
and Walther also record instances in which there was contraction in the 

a 261, May 19,1894. '- 476, 1858, ii., 396. c 36:5, xxxv.. 447. 

d 231, ix. e 476, 1861, i.. 391 f 476, 1878, i.. 11. 

g 342, Jan., 1894. 1' 274, 1877, xii., 279. i 190, cent. iv.. n. 20. 

J Observ. anat. patli., L. iv., pp. 27, 45. ^ Muntli. J. M. Sc, Loud., 1851. xii., 121. 


middle of the stomach, accounting for their instances of duplex stomach. 
Musser-'^ reports an instance of hour-glass contraction of the stomach. Hart'', 
dissected the stomach of a woman of thirty which resembled the stomach 
of a predaceous bird, with patches of tendon on its surface. The right 
extremity instead of continuously contracting ended in a culdesac one-half as 
large as the greater end of the stomach. The duodenum proceeded from the 
depression marking the lesser arch of the organ midway between the cardiac 
orifice and the right extremity. Crooks '^ speaks of a case in which the stomach 
of an infant terminated in a culdesac. 

Hernia of the stomach is not uncommon, especially in diaphragmatic or 
umbilical deficiency. There are many cases on record, some terminating 
fatally from strangulation or exposure to traumatism. Paterson '^ reports a 
case of congenital hernia of the stomach into the left portion of the thoracic 
cavitv. It was covered with fit and occu})ied the whole left half of the 
thoracic cavity. The spleen, pancreas, and transverse colon were also superior 
to the diaphragm. Death was caused by a 
well-defined round perforation at the cardiac 
curvature the size of a sixpence. 

Anomalies of the Intestines. — The 
Ephemerides contains the account of an ex- 
ample of double cecum, and Alexander ^ 
speaks of a double colon, and there are other 
cases of duplication of the bowel recorded. 
There is an instance of coalition of the 
jejunum with the liver/"* and Treuner *" 

parallels this case. Aubery, Charrier, Poel- j,.^^ i3T.-i.oabie stomach. 

man, and others speak of congenital division 
of the intestinal canal. Congenital occlusion is quite frequently reported. 

Dilatation of the colon frequently occurs as a transient affection, and by 
its action in ]Kishing up the diaphragm may so seriously interfere with the action 
of the heart' and lungs as to occasionally cause heart-foilure. Fenwick has 
mentioned an instance of this nature. According to Osier there is a chronic 
form of dilatation of the colon in which the gut may reach an enormous 
size. The coats may be hypertrophied without evidence of any special 
organic change in the mucosa. The most remarkable instance has been 
reported by Formad. The patient, known as the '' balloon-man," aged 
twenty-three at the time of his death, had had a distended abdomen from in- 
fancy. Postmortem the colon was found as large as that of an ox, the cir- 
cumference ranging from 15 to 30 inches. The weight of the contents was 
47 pounds. Cases are not uncommon in children. Osier ^ reports three well- 
marked cases under his care. Chapman '^ mentions a case in which the liver 

a 547, 1883-1884, xiv., 331. ^' 311, iv., 326. c 776, 1826, ii., 38. '1381, 1854, ii., 26. 
e 272, 1880, 11. s., iv., 511. f 160, Baud ii., 90. g 165, 1893. ^ 224, 1878, i., 566. 



Fig. 138.— Anus absent ; 
the rectum ends in the 
bladder (after Ball). 

was displaced bv dilatation of the sigmoid flexure. Mva ^ reports two cases 
of congenital dilatation and hypertrophy of the colon (megacolon congenito), 
Hirschsprung, Genersich, Faralli, Walker, and Griffiths all record similar in- 
stances, and in all these cases the clinical features were obstinate constipation 
and marked metcorismus. 

Imperforate Anus. — Cases in which the anus is imperforate or the 
rectum ends in a blind pouch are occasionally seen. In 
some instances the rectum is entirely absent, the colon 
being the termination of the intestinal tract. There are 
cases on record in which the rectum communicated with 
the anus solely by a flbromuscular cord. Anorectal 
atresia is the ordinary imperforation of the anus, in 
which the rectum terminates in the middle of the sacral 
cavity. The rectum may be deficient from the superior 
third of the sacrum, and in this position is quite inacces- 
sible for operation. 

A compensatory coalition of the bowel with the 
bladder or urethra is sometimes present, and in these 
cases the feces are voided by the urinary passages. Huxham '' mentions the 
fusion of the rectum and colon with the bladder, and similar instances are 
reported" by Dumas *^ and Baillie. Zacutus Lusitanus ^^^ describes an infant 
with an imperforate membrane over its anus who voided feces through the 
urethra for three months. After puncture of the membrane, the discharge 
came through the natural ])assage and the child lived ; jNIorgagni mentions a 
somewhat similar case iii a little girl living in Bologna, ^ 

and other modern instances have been reported. Tlie 
rectum may terminate in the vagina (Fig. 139). 

]\Iasters ^ has seen a child who lived nine days in 
whom the sigmoid flexure of the colon terminated in the 
fundus of the bladder. Guinard '^^'^ pictures a case in 
Avhich there was communication between the rectum and 
the l^ladder. In Figure 140 a represents the rectum ; b 
the bladder ; c the point of communication ; (j shows the 
cellular tissue of the scrotum. 

There is a description ^ of a girl of fourteen, other- 
wise well constituted and healtliy, who had neither external genital organs 
nor anus. There Avas a plain dermal covering over the genital and anal 
region. She ate regularly, but eveiy three days she experienced jiain in the 
umbilicus and much intestinal irritation, followed by severe vomiting of 
stercoraceous matter ; the pains then ceased and she cleansed her mouth with 
aromatic washes, remaining well until the following third day. Some of the 

a 747, An. 48, 1894, 215. b 629, n. 422. c 664, T. iii., n. 55, p. 288. 

d224, 1862, ii., 555. e 463, viii. 

Fig. 13!). — Anus is absent ; 
rectum ends in the vagina 
(after Ball). 



urine was evacuated by the mammae. The examiners displayed much desire 
to see her after puberty to note the disposition of the menstrual flow, but nq 
further observation of her case can be found. 

Fournier ^ narrates that he was called by three students, who had been try- 
hm to deliver a woman for five davs. He found a well-constituted woman of 
tweuty-two in horrible agony, who they said liad not had a passage of the 
bowels for eight days, so he prescribed an enema. The student who was 
directed to give the enema found to his surprise that there was no anus, but 
by putting his finger in the vagina he could discern the floating end of the 
rectum, which was full of feces. There was an opening in this suspended 
rectum about the size of an undistended anus. Lavage was practised by a 
cannula introduced through the opening, and a great number of cherry stones 

Fig. 140. — Abnormal junction of the rectiini and l)ladder. 

agglutinated with feces followed the water, and labor was soon terminated. 
The woman afterward confessed that she was perfectly aware of her deformity, 
but was ashamed to disclose it before. There was an analogue of this case 
found by Mercurialis ^ in a child of a Jew called Teutonicus. 

Gerster'' reports a rare form of imperforate anus, with malposition of the 
left ureter, obliteration of the ostia of both ureters, with consequent hydrone- 
phrosis of a confluent kidney. There was a minute opening into the bladder, 
which allowed the passage of meconium through the urethra. Burge '^ men- 
tions the case of what he calls " sexless child," in which there was an imper- 
forate anus and no pubic arch ; the ureters discharged upon a tuuior the size 
of a teacup extending from the umbilicus to the pubes. A postmortem 
examination confirmed the diagnosis of sexless child. 

a 302, iv., 155. b De morb. puer., L. 1. c 597, 1878, xxviii., 516. d 597, 1870, 39. 


The Liver. — The Ephemerides, Frankcnau/ von Home, Molinetti, 
Schenck,'^ and others speak of deficient or absent liver. Zacutus 
Lusitanus ^ says that he once found a mass of flesh in phice of the liver. 
Lieutand '^ is quoted as describing a postmortem examination of an adult who 
had died of hydropsy, in whom the liver and spleen were entirely missing. 
The portal vein discharged immediately into the vena cava ; this case is 
probably unique, as no authentic parallel could be found. 

Laget "^ reports an instance of supernumerary lobe in the liver. Van 
Buren ^ describes a supernumerary liver. Sometimes there is rotation, real 
or apparent, caused by transposition of the characteristics of the li\'er. 
Handy ^ mentions such a case. Kirmisson^ reports a singular anomaly 
of the liver which he calls double displacement by interversion and rota- 
tion on the vertical axis. Actual displacements of the liver as well as what 
is known as wandering liver are not uncommon. The operation for floating 
liver will be spoken of later. 

Hawkins ^ reports a case of congenital obliteration of the ductus com- 
munis choledochus in a male infant which died at the age of four and a half 
months. Jaundice appeared on the eighth day and lasted through the short 
life. The hepatic and cystic ducts Avere pervious and the hepatic duct 
obliterated. There were signs of hepatic cirrhosis and in addition an inguinal 
hernia. • 

The Gall-Bladder. — Ilarle J mentions the case of a man of fifty, in wliom 
he could find no gall-bladder ; Patterson'^ has seen a similar instance in a 
man of twenty-five. Purser ^ describes a double gall-bladder. 

The spleen has been fimnd deficient or wanting by Lebby, Parasay, and 
others, but more frequently it is seen doubled. Cabrolius,-^'^ ISIorgagni, and 
others have found two spleens in one subject ; Cheselden and Fallopius report 
three ; Fantoni mentions four found in one subject ; Guy-Patin has seen 
five, none as large as the ordinary organ -, Hollerius, Kerekringius, and others 
have remarked on multiple spleens. There is a possibility that in some of 
the cases of multiple spleens reported the organ is really single but divided 
into several lobes. Albrecht '" mentions a case shown at a meeting of the 
Vienna Medical Society of a very large number of spleens found in the meso- 
gastrium, peritoneum, on the mesentery and transverse mesocolon, in Douglas' 
pouch, etc. There was a spleen "the size of a walnut" in the usual position, 
Avith the splenic artery and vein in their normal position. Every one of these 
spleens had a capsule, was covered by peritoneum, and exhibited the histo- 
logic appearance of splenic tissue. According to the review of this article, 
Toldt explains the case by assuming that other parts of the celomic epithelium, 

a 350, n. 7. b 718, L. iii. c 831, L. ii., obs. 3. d 302^ iv., 154. 

e 242, 1874, 42. f N. York M. Times, 1853-1854, iii., 126. g 526, 1850, vi., 204. 

h242, 1880, 112. i 476, April 6, 1895. J 476, 1856, ii., 304. 

k 548, 1864, ii., 476. 1 476, 1886, ii., 1079. ni 476, 1895, i., 1346. 


besides that of the mesogastrium, are capable of formhig; splenic tissue. Jame- 
son '^ reports a case of double spleen and kidneys. Bainbrigge ^^ mentions a 
case of supernumerary spleen causing death from the patient being placed in 
the supine position in consequence of fracture of the thigh. Peevor "^ men- 
tions an instance of second spleen. Beclard and Guy-Patin have seen the 
spleen congenitally misplaced on the right side and the liver on the left ; 
Borellus and Bartholinus with others have observed misplacement of the 

The Pancreas. — Lieutaud has seen the pancreas missing and speaks of ^ 
a double pancreatic duct that he found in a man who died from starvation ; 
Bonet^^^ speaks of a case similar to this last. 

There are several cases of complete transposition of the viscera on 
record. This bizarre anomaly was probably ol)served first in 1(350 by 
Riolanus, but the most celebrated case was that of Morand in 1G60, and 
Mery described the instance later which was the subject of the following 
quatrain : — 

"La nature, peu sage et sans doute en debauche, 

Pla§a le foie au cote gauche, 

Et de mOme, vice versa, 

Le coeur ii le droite plag-a. 

Young ^ cites an example in a woman of eighty-five who died at Ham- 
mersmith, London. She was found dead in bed, and in a postmortem exami- 
nation, ordered to discover if possible the cause of death, there was seen 
complete transposition of the viscera. The heart lay with its base toward 
the left, its apex toward the right, reaching the lower Ixnxler of the 4tli rib, 
under the right mamma. The vena cava was on the left side and passed 
into the pulmonary cavity of the heart, which was also on the left side, the 
aorta and systemic ventricle being on the right. The left splenic vein was 
lying on the superior vena cava, the liver under the left ril)s, and the spleen 
on the right side underneath the heart. The esophagus was on the right of 
the aorta, and the location of the two ends of the stomach was reversed ; 
the sigmoid flexure was on the right side. Davis ^ describes a similar in- 
stance in a man. 

Herrick ^ mentions transposition of viscera in a man of twenty-five. 
Barbieux ^ cites a case of transposition of viscera in a man who was wounded 
in a duel. The liver was to the left and the spleen and heart to the right, 
etc. Albers, Baron, Beclard, Boyer, Bull, jSlackensie, liutchinson. Hunt, 
Murray, Dareste, Curran, Duchesne, Musser, Sabatier, Shrady, A^ulpian, 
Wilson, and Wehn are among others rejiorting instances of transposition 
and inversion of the viscera. 

a 435, 1874, ix., 11. t> 490, xxxviii., 1052. c 435, 1885, xx., 216. 

dHist. Anat. Med., i., 248. e 476, 1861, i., 630. ^ 476, 1879, i., 789. 

g 538, July 28, 1894. ^ Ann. de la med. physiol.. Par., xiii.,518. 


Congenital extroversion or eventration is the result of some congenital 
deficiency in the abthinihial wall ; instances are not uncommon, and some 
patients live as long as do cases of umbilical hernia proper. Ramsey* speaks 
of entire want of development of the abdominal parietes. Robertson, 
Rizzoli, Tait, Hamilton, Brodie, Denis, Dickie, Goyrand, and many others 
mention extroversion of viscera from parietal defects. The different forms 
of hernia will l)e considered in another chapter. 

There seem to be no authentic cases of complete absence of the 
kidney except in the lowest grades of monstrosities. Becker, Blasius, 
Rhodius, Baillie, Portal, Sandifort, Meckel, Schenck, and Stoll are among 
the older writers w^ho have observed the absence of one kidney. In a recent 
paper Ballowitz has collected 213 cases, from which the following extract 
has been made by the British Medical Journal : — 

"Ballowitz (Virchow's Archiv, August 5, 1895) has collected as far as 
possible all the recorded cases of congenital absence of one kidney. Exclud- 
ing cases of fused kidney and of partial atrophy of one kidney, he finds 
213 cases of complete absence of one kidney, upon which he bases the 
following conclusions : Such deficiency occurs almost twdce as often in males 
as in females, a fact, how'ever, which may be partly accounted for by the 
greater frequency of necropsies on males. As to age, 23 occurred in the 
fetus or newly b(^rn, most having some other congenital deformity, especially 
imperforate anus ; the rest were about evenly distributed up to seventy years 
of age, after which only seven cases occurred. Taking all cases together, the 
deficiency is more common on the left than on the right side ; but while in 
males the left kidney is far more commonly absent than the right, in females 
the two sides show^ the defect equally. The renal vessels were generally 
absent, as also the ureter, on the abnormal side (the latter in all except 15 
cases); the suprarenal was missing in 31 cases. The solitary kidney 
w^as almost always normal in shape and position, but much enlarged. 
Microscopically the enlargement would seem to be due rather to hyperplasia 
than to hypertrophy. The bladder, except for absence of the opening of 
one ureter, was generally normal. In a large number of cases there were 
associated deformities of the organs of generation, especially of the female 
organs, and these Avere almost invariably on the side of the renal defect ; they 
aifected the conducting portion much more than the glandular portion — that 
is, uterus, vagina, and Fallopian tubes in the female, and vas deferens or 
vesiculae seminales in the male, rather than the ovaries or testicles. Finally, 
he points out the practical bearing of the subject — for example, the proba- 
bility of calculus causing sudden suppression of urine in such cases — and 
also the danger of surgical interference, and suggests the possibility of 
diagnosing the condition by ascertaining the absence of the opening of one 
ureter in the bladder by means of the cystoscope, and also the likelihood 
a Northwest Med. and Surg. Jour., Chicago, 1857, xiv., 450. 



of its occurring where any abnormality of the genital organs is found, 
especially if this be unilateral." 

Green" reports the case of a female child in Avhicli the right kidney and 
right Fallopian tube and ovary were absent without any rudimentary struc- 
tures in their place. Guiteras and Riesman^^'^ have noted the absence of the 
right kidney, right ureter, and right adrenal in an old woman who had died of 
chronic nephritis. The left kidney although cirrhotic was very much enlarged. 

Tompsett'' describes a necropsy made on a coolie child of nearly twelve 

Fig. 141. — Renal symphysis and supernumerary Ividney (Kayer). 

months, in which it was seen that in the place of a kidney there were two 
left organs connected at the apices by a prolongation of the cortical substance 
of each; the child had died of neglected malarial fever. Sandifort*^ speaks 
of a case of double kidneys and double ureters, and cases of supernume- 
rary kidney are not uncommon, generally being segmentation of one of 
the normal kidneys. Rayer has seen three kidneys united and formed like 
a horseshoe (Fig. 141). We are quite flimiliar with the ordinary '* horse- 
shoe kidney," in which two normal kidneys are connected. 

a 224, Feb. 23, 1895. b 224, 1879, ii., 602. c 710, fasc. iii. 


There are several f^rnis of (lis]>lacement of the kidneys, the most com- 
mon being the * ' floating kidney, ' ' which is sometimes successfully re- 
moved or fixed ; Rayer has made an extensive study of this anomaly. 

The kidney may be displaced to the pelvis, and Guiuard ^^*^ quotes an 
instance in which tlie left kidney was situated in the pelvis, to the left of 
the rectum and back of the bladder. The ureter of the left side was very 
short. The left renal artery casne from the bifurcation of the aorta and the 
primitive iliacs. The right kidney was situated normally, and received from 
the aorta two arteries, whose volume did not surpass the two arteries supply- 
ing the left suprarenal capsule, which was in its ordinary place. Displace- 
ments of the kidney anteriorly are very rare. 

The ureters have been found multiple ; Griifon ^ reports the history of a 
male subject in whom the ureter on the left side was double throughout its 
whole length ; there were two vesical orifices on the left side one above the 
other ; and Morestin, in the same journal, mentions ureters double on both 
sides in a female subject. Molinetti ^"- speaks of six ureters in one person. 
Littre in 1705 described a case of coalition of the ureters. Allen*' de- 
scribes an elongated kidney with two ureters. Coeyne ^ mentions duplica- 
tion of tlie ureters on Ijoth sides. Lediberder *^* reports a case in which the 
ureter had double origin. Tyson ^ cites an instance of four ureters in an 
infant. Penrose *^ mentions the absence of the upper two-thirds of the left 
ureter, with a small cystic kidney, and there are parallel cases on record. 

The ureters sometimes have anomalous terminations either in the rectum, 
vagina, or directly in the urethra. This latter disposition is realized nor- 
mally in a numl)er of animals and causes the incessant flow of urine, result- 
ing in a serious inconvenience. Flajani speaks of the termination of the 
ureters in the pelvis ; Nebel ^' has seen them appear just beneath the umbil- 
icus ; and Lieutaud describes a man who died at thirty-five, from another 
cause, whose ureters, as large as intestines, terminated in the urethral canal, 
causing him to urinate frequently ; the bladder was absent. In the early 
part of this century ^ there was a young girl examined in Xew York whose 
ureters emptied into a reddish carnosity on the mons veneris. The urine 
dribbled continuously, and if the child cried or made any exertion it came 
in jets. The genital organs participated but little in the deformity, and with 
the exception that the umbilicus was low and the anus more anterior than 
natural, the child was well formed and its health good. Colzi* reports a 
case in which the left ureter opened externally at the left side^of the hymen 
a little below the normal meatus urinarius. There is a case described J of a 
man who evidently suifered from a patent urachus, as the urine passed in jets 

a 242, 1894. b 547, 1873-4, iv., 220. c 042, 1874, xliii., 55. 

d242, 1834-5. ix., 187. e 629, Lond., 1731, iii., 146. f 779, xl., 161. 

g Comment. Acad. Palat., vol. v., u. xii. ^ 302, iv., 159. 

i 747, May, 1895. J Jleni. de I'Acad. de Chir., vol. xxx. 



FiR. 14L>.— Triple l.hi 

as if controlled by a sphincter from his umbilicus. Littre mentions a patent 
urachus in a boy of eighteen. Congenital dilatation of the ureters is oeca-. 
sionally seen in the new-born. Shattuck °- describes a male fetus showino- 
reptilian characters in the sexual ducts. There was ectopia vesicte and pro- 
lapse of the intestine at the umbilicus ; the right kidney was elongated ; the 
right vas deferens opened into the ureter. There was persistence in a 
separate condition of the 
two ]\Iiillerian ducts which 
opened externally interior- 
ly, and there were two 
ducts near the (tpenings 
which represented anal 
pouches. Both testicles 
were in the abdomen. 
Ord '' describes a man in 
whom one of the Miillcrian 
ducts was persistent. 

Anomalies of the 
Bladder. — lihmchard, Blasius, Haller, Xebel, and Rhodius mention cases in 
whicli the bladder has been found absent and we have already mentioned some 
cases, but the instances in which the bladder has been duplex are much 
more frequent. Bourienne, Oberteuifer, Ruysch, Bartholinus, Morgagni, and 

Franck speak of vesical duj^lication. There 
is a descripticm^' of a man who had two blad- 
ders, each receiving a ureter. Biissiere*^ de- 
scribes a triple bladder, and Scibelli of 
Najjles*^ mentions an instance in a subject 
who died at fifty-seven with symptoms of re- 
tention of urine. In the illustration (Fig. 
142), i> represents the nonual bladder, A and 
C the supplementary bladders, with D and E 
their respective points of entrance into B. As 
will be noticed, the ureters terminate in the 
supplementary bladders. Fantoni ^^"^ and 
Malgetti cite instances of quintuple blad- 

The Ephemcrides speaks of a case of coalition of the bladder with the os 
pubis and another case of coalition with the omentum. Prochaska *'^- men- 
tions vesical fusion with the uterus, and we have already described union 
with the rectum and intestine. 

Exstrophy of the bladder is not rare, and is often associated with hypo- 

Fig. 143.— Dilatation of the fetal bladder. 

a Jour, of Path, and Bacter., July, 1895. 

c Jour, de Trevoux, 1702. ^629, u. 268. 

b491, 1880, 109. 
e 222, 1864, ii., 328. 


spadias, epispadias, and other malformations of the 2:enitourinary tract. It 
consists of a deficiency of the abdominal wall in the hypogastric region, in 
which is seen the denuded bladder. It is remedied by many different and 
ingenious plastic operations. 

In an occasional instance in which there is occlusion at the umbilicus 
and again at the neck of the bladder this organ becomes so distended as to 
produce a most curious deformity in the fetus. Figure 143 shows such a 

The Heart. — Absence of the heart has never been recorded in human 
beings except in the case of monsters, as, for example, the omphalosites, 
although there was a case reported and firmly believed by the ancient authors, 
—a Roman soldier in whom Telasius said he could discover no vestige of a 
heart. ^ 

The absence of one ventricle has been recorded. Schenck '^ has seen the 
left ventricle deficient, and the Ephemerides, Behr, and Kerckring*^ speak 
of a single ventricle only in the heart. Riolan ^^^ mentions a heart in which 
both ventricles were absent. Jurgens reported in Berlin, February 1, 1882, 
an autopsy on a child wlio had lived some days after birth, in which the left 
ventricle of the heart was found completely absent. Playfair*^ showed the 
heart of a child which had lived nine months in which one ventricle was 
absent. • In King's College Hospital in London there is a heart of a boy 
of thirteen in which the cavities consist of a single ventricle and a single 

Duplication of the heart, notwithstanding the number of cases reported, 
has been admitted with the greatest reserve by Geoffroy-Saint-Hilaire and 
by a number of authors. Among the celel)rated anatomists who describe 
duplex heart are Littre, Meckel, Collomb, Panum, Behr, Paullini, Rhodius, 
Winslow, and Zacutus Lusitanus. 

The Ephemerides ® cites an instance of triple heart, and Johnston ^ has 
seen a triple heart in a goose. 

The phenomenon of " blue-disease," or congenital cyanosis, is due to the 
patency of the foramen ovale, which, instead of closing at birth, persists 
sometimes to adult life. 

Perhaps the most unique collection of congenital malformations of the 
heart from persons who have reached the age of puberty was to be seen in 
London in 1895.^^^ In this collection there was an adult heart in which the 
foramen ovale remained open until the age of thirty-seven ;^ there were but 
two pulmonary valves ; there was another heart showing a large patent fora- 
men ovale from a man of forty-six ; and there was a septum ventriculorura 
of an adult heart from a woman of sixty-three, who died of carcinoma of the 
breast, in which the foramen ovale was still open and would admit the fore- 

a 302, xxxiv., 207. '^ 718, L. ii., obs. 184. c 473^ obs. 469. d 778, vol. xii., 169. 
e 104, dec. i., an. 9, obs. 108. f "Med. Bemerk. mid Uutensuch.," Band ii., 103. 


finger. This woman had shown no symptoms of the malformation. There 
were also hearts in which the interventricular septum was deficient, the 
ductus arteriosus patent, or some valvular malformation present. All these 
persons had reached puberty. 

Displacements of the heart are quite numerous. Deschamps of Laval 
made an autopsy on an old soldier which justified the expression, " He had a 
heart in his belly." This organ was found in the left lumbar region ; it had, 
with its vessels, traversed an anomalous opening in the diaphragm. Franck 
observed in the Hospital of Colmar a woman with the heart in the epigastric 
region. Ramel^ and Vetter speak of the heart under the diaphragm. 

Inversion of the heart is quite frequent, and we often find reports of 
cases of this anomaly. Fournier*^ describes a soldier of thirty years, of 
middle height, well proportioned and healthy, who was killed in a duel by 
receiving a wound in the abdomen ; postmortem, the heart was found in the 
position of the right lung ; the two lungs were joined and occupied the left 

The anomalies of the vascular system are so numerous that we shall 
dismiss tlu'm with a slight mention. Malacarne in Torino in 1784 de- 
scribed a double aorta, and Hommelius'' mentions an analogous case. The 
following case is quite an interesting anatomic anomaly : A woman since 
infancy had difficulty in swallowing, which was augmented at the epoch of 
menstruation and after exercise ; bleeding relieved her momentarily, but the 
difficulty always returned. At last deglutition became impossible and the 
patient died of malnutrition. A necropsy revealed the presence of the sub- 
clavicular artery passing between the tracheal artery and the esophagus, com- 
pressing this latter tube and opposing the passage of food. 

Anomalies of the Breasts. — The first of the anomalies of the generative 
apparatus to be discussed, although not distinctly belonging under this head, 
will be those of the mammae. 

Amazia, or complete absence of the breast, is seldom seen. Pilcher ^ de- 
scribes an individual who passed for a female, but who was really a male, in 
whom the breasts were absolutely wanting. Foerster, Froriep, and Ried cite 
instances associated Avith thoracic malformation. Greenhow^® reports a case 
in which the mammse were absent, although there were depressed rudimentary 
nipples and areolae. There were no ovaries and the uterus was congenitally 

There was a negress spoken of in 1842 in whom the right breast was 
missing, and there are cases of but one breast, mentioned by King,^ Paull, s 
and others.*^ Scanzoni has observed absence of the left mamma w^ ith ab- 
sence of the left ovary. 

a 462, tome xlix., p. 423. b 302, iv., 150. c 282, 1737. 

d476, 1878, i., 915. e 550, 1864, 195. f 548, 1858. 

g 476, 1862, i., 648. t These de Paris, ann. x., No. 53, p. 15. 



Micromazia is not so rare, and is generally seen in females with associate 
genital troubles. Excessive development of the mammae, generally being 
a pathologic phenomenon, will be mentioned in another chapter. How- 
ever, among some of the indigenous negroes the female breasts are naturally 
very large and pendulous. This is well shown in Figure 144, which represents 
a woman of the Bushman tribe nursing an infant. The breasts are sufficiently 
pendulous and loose to be easily thrown over the shoulder. 

Polymazia is of much more frequent occurrence than is supposed. 
Julia, the mother of Alexander Severus, was surnamed " Mammea " be- 
cause she had supernumerary breasts. Anne Boleyn, the unfortunate wife 
of Henry VIII. of England, was reputed to have had six toes, six fingers, 

and three breasts. Lyneeus says that 
in his time there existed a Roman 
woman with four mamma?, very beau- 
tiful in contour, arranged in two lines, 
regularly, one above the other, and all 
giving milk in abundance. Rubens has 
pictured a woman with four breasts ; 
the ])ainting may be seen in the Louvre 
in Paris. 

There was a young and wealthy 
heiress who addressed herself to the 
ancient faculty at Tubingen, asking, as 
she displayed four mammse, whether, 
should she marry, she would have three 
or four children at a liirth. This was 
a belief with which some of her elder 
matron friends had inspired her, and 
which she held as a hindrance to mar- 

Leichtenstern, who has collected 70 
cases of polymazia in females and 22 in males, thinks that accessory breasts 
or nipples are due to atavism, and that our most remote interiorly organized 
ancestors had many breasts, but that by constantly bearing but one child, 
from being polymastic, females have gradually become bimastic. Some of 
the older philosophers contended that by the presence of two breasts woman 
was originally intended to bear two children. 

Hirst ^ says : " Supernumerary breasts and nipples are more common 
than is generally supposed. Bruce found GO instances in 3956 persons 
examined (1.56 per cent.). Leichtenstern places the frequency at one in 500. 
Both observers declare that men present the anomaly about twice as fre- 
quently as women. It is impossible to account for the accessory glands on 

a 792, May, 1896. 

Fig. 144. — Bushwouian nursing her infant. 



the theory of reversion, as they occur with no regularity in situation, })ut may 
develop at odd places on the body. The most frequent position is on the 
pectoral surface below the true mamraje and somewhat nearer the middle 
line, but an accessory gland has been observed on the left shoulder over the 
prominence of the deltoid, on the abdominal surface below the costal carti- 
lages, above the umbilicus, in the axilla, in the groin, on the dorsal sur- 
face, on the labium majus, and on the outer aspect of the left thigh. 
Ahlfeld explains the presence of mammie on odd parts of the Ijod}' by the 
theory tliat portions of the embryonal material entering into the com|)()sition 
of the mammary gland are carried to and implanted upon any portion of the 
exterior of the body by means of the amnion." 

Possibly the greatest number of accessory mammae 
reported is that of Neugebauer in 188G, who found 
ten in one person. Peuch in LS76 collected 77 cases, 
and since then Hamy, Quinquaud, Whiteford, Eng- 
strom, and ]\Iitchell Bruce have collected cases. 
Polymazia must have been known in the olden times, 
and we still have before us the old images of Diana, 
in which this goddess is portrayed with numerous 
breasts, indicating her ability to look after the grow- 
ing; child. Fio-ure 145 shows an ancient Oriental 
statue of Artemisia or Diana now at Naples. 

Bartholinus ^ has observed, a Danish woman with 
three mammte, two ordinarily formed and a third form- 
ing a triangle ^^'ith the others and resembling the 
breasts of a fat man. In the village of Phullendorf 
in Germany early in this century there was an old 
woman who sought alms from place to place, exhibit- 
ing to the curious four symmetrical breasts, arranged 
parallel. She was extremely ugly, and when on all 
fours, with her breasts pendulous, she resembled a 
beast. The authors have seen a man with six distinct nipples, arranged as 
regularly as those of a bitch or sow. The two lower ^veve quite small. This 
man's body was covered with heavy, long hair, making him a very conspicuous 
object when seen naked during bathing. The hair was absent for a space of 
nearly an inch about the nipples. Borellus speaks of a woman with three 
mammae, two as ordinarily, the third to the left side, which gave milk, but 
not the same quantity as the others. Gardiner'' describes a mulatto woman 
who had four mammae, t^vo of which were near the axillae, about four inches 
in circumference, with proportionate sized nipples. She became a mother at 
fourteen, and gave milk from all her breasts. In his " Dictionnaire Philo- 
so})liique " Voltaire gives the history of a woman with four Avell-formed 

a 190, cent. iv. b 302, iv., 152. 

Fig 14t — statue ot a i olvmas- 
tic Artemisia or Diana. 



and symmetrically arranged breasts ; she also exhibited an excrescence, covered 
with a nap-like hair, looking like a cow-tail. Percy thonght the excrescence 
a prolongation of the coccyx, and said that similar instances were seen in 
savage men of Borneo. 

Percy '"^ says that among some prisoners taken in Anstria was found a 
woman of Valachia, near Roumania, exceedingly fatigued, and suffering 
intensely from the cold. It was Januar}', and the ground was covered with 
three feet of snow. She had been exposed with her two infants, who had been 
born twenty days, to this freezing temperature, and died on the next day. 
An examination of her body revealed five mamnipe, of which four projected as 
ordinarily, while the fifth was about the size of that of a girl at puberty. 

Fig. 146. — Woman with two axillary mammse (Charjieutierj. 

They all had an intense dark ring about them ; the fifth was situated 
about five inches above the umbilicus. Percy injected the subject and di.s- 
sected and described the mammary blood-supply. Hirst'' mentions a 
negress of nineteen who had nine mammse, all told, and as many nipples. 
The t\\'o normal glands Mere veiy large. Two accessory glajids and nipples 
below them were small and did not excrete milk. All the other glands and 
nipples gave milk in large quantities. There were five nipples on the left and 
four on the right side. The patient's mother had an accessory mamma on the 
abdomen that secreted milk during the period of lactation. 

Charpentier has observed in his clinic a woman with two supplementary 
a 302, iv., 152. b 792, May, 1896. 



axillary mamnife with nipples. They gave milk as the ordinary mammse 
(Fig. 146). Robert saw a woman who nourished an infant by a mamma on 
the thigh. Until the time of pregnancy this mamma was taken for an ordi- 
nary nevus, but with pregnancy it began to develop and acquired the size of 
a citron. Figure 147 is from an old wood-cut showing a child suckling at a 
supernumerary mamma on its mother's thigh while its brother is at the 
natural breast. Jenner speaks of a breast on the outer side of the thigh four 
inches below the great trochanter. Hare'' describes a woman of thirty- 
seven who secreted normal milk from her axillae. Lee ^ mentions a woman 
of thirty-five with four mammae and four nipples ; she suckled with the 
pectoral and not the axillary breasts. McGillicudy describes a pair of rudi- 
mentary abdominal mammae, and there is another similar case recorded. *-' Har- 
tung '^ mentions a woman of thirty 
who while suckling had a mamma 
on the left labium majus. It was 
excised, and microscopic examina- 
tion showed its structure to be that 
of a rudimentary nipple and mam- 
mary gland. Leichtenstern cites 
a case of a mamma on the left 
shoulder nearly under the insertion 
of the deltoid, and Klob ^ speaks 
of an acromial accessory mamma 
situated on the shoulder over the 
greatest prominence of the deltoid. 
Hall ^ reports the case of a func- 
tionally active supernumerary 
mamma over the costal cartilage 

of the 8tli rib. Jussieu s speaks 
of a woman who had three breasts, 
one of which was situated on the 

groin and with which she occasionally suckled ; her mother had three breasts, 
but they were all situated on the chest. Saunois^ details an account of a 
female who had two supernumeraiy breasts on the back. Bartholinus 
(quoted by Meckel) and Manget also mention mammae on the back, but 
Geoffroy-Saint-Hilaire questions their existence. Martin ^ gives a very clear 
illustration of a woman with a supernumerary breast below t\ie natural organ 
(Fig. 148). Sneddon,J who has collected quite a number of cases of poly- 
mazia, quotes the case of a woman who had two swellings in each axilla in 

Fig. 147. — Functional supernumerary mamma on the thigh. 

a 476, 1860, ii., 405. 

d luaug. diss., Erlaugen, 1872. 

f Quart. Med. Jour., April, 1894. 

i Archiv. fur Klinische Chirurgie, 1893 

b 550, xxi., 266. 

g 476, xii., 618. 

c 451, 1878, xiii., 425. 
e 833, 1858, i., 52. 
^ These de Paris. 
J 381, 1879, p. 92. 



which gland-structure was made out, but with no external openings, and which 
had no anatomic connection with the mammary glands proper. Shortly after 
birth tliev varied in size and proportion, as the breasts were full or empty, and 
iu five weeks all traces of them were lost. Her only married sister had 
similar enlargements at her third confinement. 

Polymazia sometimes seems to be hereditary. Robert saw a daughter 
whose mother was polyniastic, and Woodman ^ saAV a mother and eldest 
daughter who each had three nij)])les. Lousier'^ mentions a woman wanting 
a mamma who transmitted this vice of conformation to her daughter. 
Handyside savs he knew two brothers in both of whom breasts were wanting. 
Supernumerary nipples alone are also seen, as many as five having been 

found on the same breast. Neuge- 
bauer reports eight supernume- 
rary nijiples in one case. Hollerus 
has seen a woman who had two 
nipples on the same l^reast which 
gave milk with the same regu- 
larity and the same al)undance as 
the single nipple. The Ephem- 
erides contains a descrijjtion of 
a triple nipple. Barth ^ describes 
a " mamma erratica " on the face 
in front of the right ear which 
enlarged during menstruation. 

Cases of deficiency of the 
nipples have been reported by 
the Ephemerides, Lentilius, Se- 
verinus, and AVerckardus. 

Cases of functional male mam- 
mae will be discussed iu Chapter 

Fig. 14R.-Supermimerary breast (Martin). COmplCte absenCe Of thC 

hymen is very rare, if we may 
accept the statements of Devilliers, Tardieu, and Brouardel, as they have 
never seen an example in the numerous young girls they have examined from 
a medico-legal point of view. 

Duplication or biperforation of the hymen is also a very rare anomaly 
of this membrane. In this instance the hymen generally presents two 
lateral orifices, more or less irregular and separated by a membranous band, 
which gives the appearance of duplicity. Roze reported from Strasburg 
in 1866 a case of this kind, and Delens'' has observed two examples of 

a 778, ix., 50. ^ "Dissert, sur la lactation," Paris, 1802, p. 15. 

c 161, 1888, 569. <i " Aunales d'hygieiie publique et de medeciue legale," 1877. 


biperforate hymen, which show very well that this disposition of the mem- 
brane is due to a vice of conformation. The first was in a girl of eleven,. 
in which the membrane was of the usual size and thickness, but was dupli- 
cated on either side. In her sister of nine the hvmen was normallv con- 
formed. The second case was in a girl under treatment bv Cornil in 1876 
for vaginitis. Her brother had accused a young man of eighteen of having 
violated her, and on examination the hymen showed a biperforate conforma- 
tion ; there were two oval orifices, their greatest diameter being in the ver- 
tical plane ; the openings were situated on each side of the median line, 
about five mm. apart ; the dividing band did not appear to be cicatricial, l)ut 
presented the same roseate coloration as the rest of the hymen. Since this 
report quite a number of cases have been recorded. 

The dilferent varieties of the hymen will be left to the works on obstet- 
rics. As has already been observed, labor is frequently seriously complicated 
by a persistent and tough hymen. 

Deficient vulva may be caused by the persistence of a thick hymen, bv 
congenital occlusion, or by absolute absence in vulvar structure. Bartholinus, 
Borellus, Epliemerides, Julius, Vallisneri, and Baux are among the older 
writers who mention this anomaly, but as it is generally associated with 
congenital occlusion, or complete absence of the vagina, the two Avill be con- 
sidered together. 

Complete absence of the vagina is quite rare. Baux •'^ reports a case 
of a girl of fourteen in whom " there was no trace of fundament or of o-enital 
organs." Olierteuffer '' speaks of a case of absent vagina. A'icq d'Azir "^ is 
accredited with liaving seen two females who, not having a vagina, copulated 
all through life by the urethra, and Fournier sagely remarks that the extra 
large urethra may have been a special dispensation of nature. Bosquet'^ 
describes a young girl of twenty with a triple vice of conformation — an 
obliterated vulva, closure of the vagina, and absence of the uterus. Men- 
strual hemorrhage took ])lace from the gums. Clarke ^ has studied a similar 
case which was authenticated by an autopsy. 

O'Ferral of Dublin, Gooch, Davies, Boyd, Tyler Smith, Hancock, 
Coste, Kluyskens, Debrou, Braid, Watson, and others are quoted by Churchill 
as having mentioned the absence of the vagina. Amussat ^ observed a Ger- 
man girl who did not have a trace of a vagina and who menstruated regularly. 
Griffith s describes a specimen in the ^Museum of St. Bartholomew's Hospital, 
London, in which the ovaries lay on the surface of the pelvic peritoneum 
and there was neither uterus nor vagina ; the pelvis had some of the charac- 
teristics of the male type. Matthews Duncan has observed a somewhat 
similar case, the vagina not measuring more than an inch in length. Fer- 
guson ^ describes a prostitute of eighteen who had never menstruated. The 

a 460, 1758, viii., 59. b 160, Band ii., 627. c 302^ iv.^ 162. 

a 778, xxvii., 123. e 476, 1872, ii., 225. f 368, Dec. 12, 1865. 

Z 778, xxvii., 128. h Plauet, N. Y. , 1883, 1. 


labia were found well developed, but there was no vagina, uterus, or ovaries. 
Coitus had been through the urethra, which was considerably distended, 
though not causing incontinence of urine. Hulke reports a case of congeni- 
tal atresia of the vagina in a brunette of twenty, menstruation occurring 
through the urethra. He also mentions the instance of cong-enital atresia of 
the vagina with hernia of both ovaries into the left groin in a servant of 
twenty, and the case of an imperforate vagina in a girl of nineteen with an 
undeveloped uterus. 

Brodhurst'"* reports an instance of absence of the vagina and uterus in a 
girl of sixteen who at four years of age showed signs of approaching puberty. 
At this early age the mons was covered with hair, and at ten the clitoris was 
three inches long and two inches in circumference. The mammae were well 
developed. The labia descended laterally and expanded into folds, resembling 
the scrotum. 

Azema ^ reports an instance of complete absence of the vagina and im- 
permeability and probable absence of the col uterinus. The deficiencies 
were remedied by operation. B6rard ^ mentions a similar deformity and 
operation in a girl of eighteen. Gooding*^ cites an instance of absent va- 
gina in a married woman, the uterus discharging the functions. Gosselin ® re- 
ports a case in wliich a voluminous tumor was formed by the retained men- 
strual fluid in a woman without a vagina. An artificial vagina was created, 
but the patient died from extravasation of blood into the peritoneal cavity. 
Carter, Polaillon, Martin, Curtis, Worthington, Hall, Hicks, Moliere, Patry, 
Dolbeau, Desormeaux, and Gratigny also record instances of absence of the 

There are some cases reported in extramedical literature which might 
be cited. Bussy Rabutin in his ]\Iemoires in 1639 speaks of an instance. 
The celebrated Madame R6camier was called by the younger Dumas an 
involuntary virgin ; and in this connection could be cited the malicious 
and piquant sonnet : — 

Chateaubriand et Madame Recamier. 

" Juliette et Rene s'aimaient d' amour si tendre 
Que Dieu, sans les punir, a pu leur pardonner : 
II n'avait pas voulu que Tune put donner 
Ce que 1' autre ne pouvait prendre." 

Duplex vagina has been observed by Bartholinus, ]\Ialacarne, Asch, 
Meckel, Osiander, Purcell, and otlier older writers. In more modern times 
reports of this anomaly are quite frequent. Hunter *" reports a case of labor 
at the seventh month in a woman with a double vagina, and delivery through 
the rectum. Atthill and Watts speak of double vagina with single uterus. 

a 548, 1852, 187. b 140, 193. c 363, 1841, iii., 377. 

d476, 1879, i., 430. e 363, xl., 225. f 125, xi., 593. 


Robb ^ of Johns Hopkins Hospital reports a case of double vagina in a pa- 
tient of twenty suffering from dyspareunia. The vaginal orifice was con- 
tracted ; the urethra was dilated and had evidently been used for coitus. A 
membrane divided the vagina into two canals, the cervix lying in the right 
half; the septum was also divided. Both the thumbs of the patient were so 
short that their tips could scarcely meet those of the little fingers. Double 
vagina is also reported by Anway, Moulton, Freeman, Frazer, Haynes, Le- 
maistre, Boardmau, Dickson, Dunoyer, and Rossignol. This anomaly is 
usually associated with bipartite or double uterus. Wilcox ^^ mentions a 
primipara, three months pregnant, with a double vagina and a bicornate 
uterus, who was safely delivered of several children. Haller and Borellus 
have seen double vagina, double uterus, and double ovarian supply ; in the 
latter case there was also a double vulva. Sanger ^ speaks of a supernu- 
merary vagina connecting with the other vagina by a fistulous opening, and 
remarks that this was not a case of patent Gartner's duct. 

Cullingworth "^ cites two cases in which there were transverse septa of 
the vagina. Stone ^ reports five cases of transverse septa of the vagina. 
Three of the patients were young women who had never borne children or 
suffered injury. Pregnancy existed in (>aeh case. In the first the septum was 
about two inches from the introitus, and contained an opening about J inch 
in diameter which admitted the tip of the finger. The membrane was elastic 
and thin and showed no signs of inflammation. ^Menstruation had alwaVs 
been regular up to the time of pregnancy. The second was a duplicate of 
the first, excepting that a few bands extended from the cervix to the mem- 
branous septum. In tlie third the lumen of the vagina, al)Out two inches 
from the introitus, was distinctly narro\ved by a ridge of tissue. There was 
uterine displacement and some endoeervicitis, but no history of injury or 
operation and no tendency to contraction. The two remaining cases occurred 
in patients seen by Dr. J. F. Scott. In one the septum was about If inches 
from the entrance to the vagina and contained an orifice large enough to 
admit a uterine probe. During labor the septum resisted the advance of the 
head for several hours, until it was slit in several directions. In the other, 
menstruation had always been irregular, intermissions being followed by a 
profuse flow of black and tarry blood, which lasted sometimes for fifteen days 
and was accompanied by severe pain. The septum was 1^ inches from the 
vaginal orifice and contained an opening which admitted a uterine sound. 
It was very dense and tight and fully | inch in thickness. ^ 

Mordie^ reported a case of congenital deficiency of the rectovaginal 
septum which was successfully remedied l)y operation. 

Anomalous Openings of the Vagina. — The vagina occasionally opens 
abnormally into the rectum, into the bladder, the urethra, or upon the 

a 446, April, 1895. b 647, 1877. c 261. Sept. 22, 1894. 

d476, 1889, i., 726. e 218, May 30, 1895. f 476, 1888, ii., 166. 



abdominal parietes. Kossi reports from a hospital in Turin the case of a 
Piedmontese girl in whom there was an enormous tumor corresponding to 
the opening of the vaginal orifice ; no traces of a vagina could be found. 
The tumor was incised and proved to be a living infant. The husband of 
the woman said that he had coitus without difficulty by the rectum, and 
examination showed that the vagina opened into the rectum, by which means 
impregnation had been accomplished. Bonnain '^ and Payne ^' have observed 
analogous cases of this abnormality of the vaginal opening and subsequent 
accouchement by the anus. Payne's case was of a woman of thirty-five, well 
formed, who had been in labor thirty-six hours, when the physician examined 
and looked in vain for a vaginal opening ; the finger, gliding along the 
perineum, came in contact with the distended anus, in which was recognized 
the head of the fetus. The woman from prolongation of lal)or was in a 
complete state of prostration, which caused uterine inertia. Payne anes- 
thetized the patient, applied the forceps, and extracted the fetus without 
further accident. The vulva of this woman five months afterward displayed 
all the characteristics of virginity, the vagina opened into the rectum, and 
menstruation had alwa^'s been regular. This woman, as ^vell as her husband, 
averred that they had no suspicion of the anomaly and that coitus (by the 
anus) had always been satisfactory. 

Oj^ening of the vagina upon the parietes, of which Le Fort has collected 
a numl)cr of cases, has never been observed in connection with a viable fetus. 

Absence of the labia majora has been observed, especially by Pozzi, to 
the exclusion of all other anomalies. It is the rule in exstrophy of the 

Absence of the nymphae has also been observed, particularly by 
Auvard and by Perchaux, and is generally associated with imperfect develop- 
ment of the clitoris. Constantinedes '^ reports absence of the external 
organs of generation, probal)ly also of the uterus and its appendages, in a 
young lady. Van Haartman, LeFort, Magee, and Ogle cite cases of 
absence of the external female organs. Kiolan '^ in the early part of the 
seventeenth century reported a case of defective nymphae ; Neubauer in 
1774 offers a contrast to this case in an instance of triple nymphae. 

The nymphae are sometimes enormously enlarged by hypertrophy, by 
varicocele, or by elephantiasis, of which latter type Rigal de Gaillac has 
observed a most curious case. There is also a variety of enlargement of the 
clitoris which seems to be constant in some races ; it may be a natural hyper- 
trophy, or perhaps produced by artificial manipulation. * 

The peculiar conditions under which the Chinese women are obliged to 
live, particularly their mode of sitting, is said to have the effect of causing 
unusual development of the mons veneris and the labia majora. On 
the other hand, some of the lower African races have been distinguished by 

a 789, Sept. 4, 1888. b 168, 1886, p. 854. c 250, 1870-1, iii., 77. d 685, L. ii., c. 35. 


the deficiency in development of the labia majora, nions veneris, and genital 
hair. In this respect they present an approximation to the genitals of the . 
anthropoid apes, among whom the orang-outang alone shows any tendency to 
formation of the labia majora. 

The labial appendages of the Hottentot female have been celebrated for 
many years. Blumenbach and others of the earlier travelers found that the 
apron-like appearance of the genitals of the Hottentot women was due to 
abnormal hypertrophy of the labia and nymphse (PI. 5). According to John 
Knott, the French traveler, Le Vaillant, said that the more coquettish among 
the Hottentot girls are excited by extreme vanity to practise artificial elongation 
of the nympha and labia. They are said to pull and rub tliese parts, and even 
to stretch them by hanging weights to them. Some of them are said to spend 
several hours a day at this process, which is considered one of the important 
parts of the toilet of the Hottentot belle, this malformation being an attrac- 
tion for the male members of the race. Merensky says that in Basuto- 
land the elder w^omen begin to practise labial manipulation on their female 
children shortly after infancy, and Adams has found this custom to prevail 
in Dahomey ; he says that the King's seraglio includes 3000 members, the 
elect of his female subjects, all of whom have labia up to the standard of 
recognized length. Cameron found an analogous practice among the women 
of the shores of Lake Tanganyika. The females of this nation manipulated 
the skin of the lower part of the abdomens of the female children from 
infancy, and at puberty these women exhibit a cutaneous curtain over the 
genitals which reaches half-way down the thighs. 

A corresponding development of the preputian clitorides, attaining the 
length of 18 mm. or even more, has been observed among the females of 
Bechuanaland. The greatest elongation measured by Barrow was five inches, 
but it is quite probable that it was not possible for him to examine the 
longest, as the females so gifted generally occupied very high social positions. 

Morgagni describes a supernumerary left nympha, and Petit is accred- 
ited with seeing a case which exhibited neither nymphae, clitoris, nor urinary 
meatus. Mauriceau performed nymphotomy on a woman whose nymplise were 
so long as to render coitus difficult. Morand ^'^ quotes a case of congenital 
malformation of the nymphse, to which he attributed impotency. 

There is sometimes coalition of the labia and nymphae, which may be 
so firm and extensive as to obliterate the vulva. Debouf* has reported a 
case of absence of the vulva in a woman of twenty upon whom he operated, 
which was the result of the fusion of the labia minora, and this with an en- 
larged clitoris gave the exteral appearance of an hermaphrodite. 

The absence of the clitoris coincides with epispadias in the male, and in 
atrophy of the vulva it is common to find the clitoris rudimentary ; but a 
more frequent anomaly is hypertrophy of the clitoris. 

a 235, 18G4, 26, tome xlv. 


Among the older authorities quoting instances of enlarged clitorides are 
Bartholiuus, Schenck, Helhvig, lihodius, Riolauus, and Zacchias. Albu- 
casis"° describes an operation for enlarged clitoris, Chabert ligated one, 
and Riedlin ^ gives an instance of an enlarged clitoris, in which there appeared 
a tumor synchronous with the menstrual epoch. 

AVe learn from the classics that there were certain females inhabiting 
the borders of the ^li^gean Sea who had a sentimental attachment for one 
another which was called " Lesbian love," and which carried them to the 
highest degree of frenzy. The immortal effusions of Sappho contain refer- 
ences to this passion. The solution of this peculiar ardor is found in the 
fact that some of the females had enlarged clitorides, strong voices, robust 
figures, and imitated men. Their manner was imperative and authoritative 
to their sex, who worshiped them with perverted devotion. We find in 
Martial ^ mention of this perverted love, and in the time of the dissolute 
Greeks and Romans ridiculous jealousies for unfaithfulness between these 
women prevailed. Aetius said that the Egyptians practised amputation of 
the clitoris, so that enlargement of this organ must have been a common vice 
of conformation along the Xile. It was also said that the Egyptian women 
practised circumcision on their females at the age of seven or eight, the time 
chosen being when the Nile was in flood. Bertherand ° cites examples of 
enlarged' clitorides in Aral) women ; Bruce testifies to this circumstance in 
Abyssinia, and Mungo Park has observed it in the Mandingos and the Ibbos. 

Sonniui ^ says that the women of Egypt had a natural excrescence, fleshy 
in consistency, quite thick and pendulous, coming from the skin of the mons 
veneris. Sonniui says that in a girl of eight he saw one of these caruncles 
which was J inch long, and another on a woman of twenty which was four 
inches long, and remarks that they seem peculiar only to Avomen of distinct 
Egyptian origin. 

Duhouset ® says that in circumcision the Egyptian women not only 
remove a great part of the body of the clitoris with the prepuce, but also 
adjacent portions of the nymphre ; Gallieni ^ found a similar operation cus- 
tomary on the upper l)anks of the Niger. 

Otto at Breshui in 1824 reports seeing a negress with a clitoris 4| 
inches long and IJ inches in the transverse diameter ; it projected from the 
vulva and when supine formed a complete covering for the vaginal orifice. 
The clitoris may at times become so large as to prevent coitus, and in France 
has constituted a legitimate cause for divorce. This organ is very sensitive, 
and it is said that in cases of supposed catalepsy a woman cannot bear titilla- 
tion of the clitoris without some visible movement. 

Columbus cites an example of a clitoris as long as a little finger ; Haller 

a 683, 1695, 295. '• 509, L. i., epigram 91. c " Med. et Hygiene des Arabes," p. 190. 
'1 "Voyage dans la Haute et la Basse-Egypt.," Paris, 1799. e 243, xii., 126. 

f Bull, de la Soc. de Geog., iv., 1883, 573. 



mentions one which measured seven inches, and there is a record ^ of an 
enlarged clitoris which resembled the neck of a goose and which was 12 
inches long. Bainbridge ^ reports a case of enlarged clitoris in a woman of 
thirtv-two who was confined with her first child. This organ was five inches 
in length and of about the diameter of a quiescent penis. Figure 149 
shows a well-marked case of hypertrophy of the clitoris. Rogers ° describes 
a woman of twenty-five in a reduced state of health with an enormous clitoris 
and warts about the anus ; there w^ere also manifestations of tuberculosis. On 
questioning her, it w^as found that she had formerly masturbated ; later she 
had sexual intercourse several times with a young man, but after his death she 
commenced self-abuse again, which brought on the present enlargement. 
The clitoris was ligated and came away without leaving disfigurement. 
Cassano and Pedretti of 
Naples reported an instance 
of monstrous clitoris in 
1860 before the Academy 
of Medicine. 

In some cases ossifica- 
tion of the clitoris is ob- 
served. Fournier ■^°- speaks 
of a public woman in Venice 
who had an osseous clitoris ; 
it was said that men having 
connection with her invari- 
ably suffered great pain, fol- 
lowed by inflammation of 
the penis. 

There are a few instances 
recorded of bifid clitoris, 
and Arnaud ^ cites the his- 
tory of a woman who had a double clitoris. Secretain ^ speaks of a clitoris 
whicli was in a permanent state of erection. 

Complete absence of the ovaries is seldom seen, but there are 
instances in which one of the ovaries is missing. Hunter, Vidal, and 
Chaussier report in full cases of the absence of the ovaries, and Thudicum 
has collected 21 cases of this nature. Morgagni, Pears, ^ -and Cripps have 
published observations in which both ovaries were said to have been absent. 
Cripps speaks of a young girl of eighteen who had an infantile uterus and 
no ovaries ; she neither menstruated nor had any signs of puberty. Lauth 
cites the case of a wa^man whose ovaries and uterus were rudimentary, and 
who exhibited none of the principal physiologic characteristics of her sex ; 

Fig. 149. — Hypertrophy of the clitoris. 

a 302, v., 374. b 543, I860, i., 45. c 778, xii., 84. 
e Soc. d. sc. med. de Gaunat., xxiii., 1868-9, 22. 

d " Mem. de Chinirg.," tome i. 
f 629, 1805, 225. 


on tlie otlier hand, Ruband describes a woman with only rudimentary 
ovaries who was very passionate and quite feminine in her aspect. 

At one time the existence of genuine supernumerary ovaries was 
vigorously disputed, and the older records contain no instances, but since 
the researches of Beigel, Puech, Thudicnm, Winckler, de Sinety, and Paladino 
the presence of multiple ovaries is an incontestable fact. It was originally 
thought that supernumerary ovaries as well as supernumerary kidneys were 
simply segmentations of the normal organs and connected to tliem by por- 
tions of the proper substance ; now, however, by the recent reports we are 
warranted in admitting these anomalous structures as distinct organs. It has 
even been suggested that it is the persistence of these ovaries that causes the 
menstruation of which we sometimes hear as taking place after ovariotomy. 
Sippel ''' records an instance of third ovary , Mangiagalli ^^ has found a 
supernumerary ovary in the body of a still-born child, situated to the inner 
side of the normal organ. Winckel discovered a large supernumerary 
ovary connected to the uterus by its own ovarian ligament. Klebs found two 
ovaries on one side, both consisting of true ovarian tissue, and connected by 
a band | inch long. 

Doran divides supernumerary ovaries into three classes : — 

(1) The ovarium succentauriatum of Beigel. 

(2) Those cases in which two masses of ovarian tissue are separated by 
ligamentous bands. 

(3) Entirely separate organs, as in Winckel's case. 

Prolapsus or displacement of the ovaries into the culdesac of 
Douglas, the vaginal wall, or into the rectum can be readily ascertained by 
the resulting sense of nausea, particularly in defecation or in coitus. Munde, 
Barnes, Lentz, INIadden, and Ileywood Smith report instances, and Cloquet 
describes an instance of inguinal hernia of the ovary in which the uterus 
as well as the Fallopian tube were found in the inguinal canal. Debierre*' 
mentions that Puech has gathered 88 instances of inguinal hernia of the 
ovary and 14 of the crural type, and also adds that Otte*^ cites the only 
instance in which crural ovarian hernia has been found on both sides. Such 
a condition with other associate malformations of the genitalia might easily 
be mistaken for an instance of hermaphroditic testicles. 

The Fallopian tubes are rarely absent on either side, although Bla- 
sius ^^^ reports an instance of deficient oviducts. Blot ® reports a case of atro- 
phy, or rather rudimentary state of one of the ovaries, with absence of the tube 
on that side, in a woman of forty. 

Doran '^ has an instance of multiple Fallopian tubes, and Richard, in 
1851, says several varieties are noticed. These tubes are often found fused 

a 261, 1889, No. 18. 1^152, 1879, i., 149. 

c " Les vices (le conformation des organs geuitaux," etc. Par., 1892. ^igg^ 1857, 345. 
e "Compt. rend. Soc. de biol.," iii., 176. Par., 1857. f 778, 1887. 


or adherent to the ovary or to the uterus; but Fabricius'^^'^ describes the 
symphysis of the Fallopian tube with the rectum. 

Absence of the uterus is frequently reported. Lieutaud and Richer- 
and^°- are each said to have dissected female subjects in whom neither the 
uterus nor its annexed organs were found. Many authors are accredited with 
mentioning instances of defective or deficient uteri, among them Bosquet, "■ 
Boyer,'' Walther,^'^ Le Fort, Calori, Pozzi, Munde, and Strauch. Balade •= 
has reported a curious absence of the uterus and vagina in a girl of eighteen. 
Azam, Bastien, Bibb, Bovel, Warren, Ward, and many others report similar 
instances, and in several cases all the adnexa as well as the uterus and vagina 
were absent, and even the kidney and bladder malformed. 

Phillips '^ speaks of two sisters, both married, with congenital absence of 
the uterus. In his masterly article on " Heredity," ^ Sedgwick quotes an in- 
stance of total absence of the uterus in three out of five daughters of the 
same family ; two of the three were twice married. 

Double uterus is so frequently reported that an enumeration of the cases 
would occupy several pages. Bicorn, bipartite, duplex, and double uteruses are 
so called according to the extent of the duplication. The varieties range all 
the way from slight increase to two distinct uteruses, with separate appendages 
and two vaginse. ISIeckel, Boehmer, and C^allisen are among the older writers 
who have observed double uterus with associate double vag-ina. Figure 150 
represents a transverse section of a bipartite uterus with a double vagina. 
The so-called uterus didelphus is really a duplex uterus, or a veritable double 
uterus, each segment having the appearance of a complete unicorn uterus 
more or less joined to its neighbor (Fig. 151). Yallisneri ^ relates the history 
of a woman who was poisoned by cantharides who had two uteruses, one open- 
ing into the vagina, the other into the rectum. jNIorand, Bartholinus, Tiede- 
mann, Ollivier, Blundell, and many others relate instances of double uterus in 
which impregnation had occurred, the fetus being retained until the full term. 

Purcell of Dublin^ says that in the summer of 1773 he opened the body 
of a woman who died in the ninth month of pregnancy. He found a uterus 
of ordinary size and form as is usual at this period of gestation, which con- 
tained a full-grown fetus, but only one ovary attached to a single Fallopian 
tube. On the left side he found a second uterus, unimprcgnated and of usual 
size, to which another ovary and tube were attached. Both of these uteruses 
were distinct and almost entirelv separate. 

Pregnancy with Double Uterus. — Hollander'' describes the folloAving 
anomaly of the uterus which he encountered during the performance of a 
celiotomy : — 

" There were found two uteruses, the posterior one being a normal organ 

a 462, iv., 128. '' 565, ii., 19. c j„nr. de Medicine de Bordeaux, Oct. 4, 1891. 

<i224, June 18, 1870. e 549^ juiy^ 1863, 457. f " Esperienze d'osservaz.," etc 
E 629, Ixiv., 474. Ii261, 1895, No. 4, p. 375. 


Fig. 150. — Bipartite uterus with double vagina. 

Fig. 151.— Didelphic uterus and divided vagina: 
n, right segment; 6, left segment; c, d, right ovary and 
round ligament; /, e, left ovai-y and round ligament; 
g,j, left cervix and vagina; k, vaginal septum; h, i, 
right cervix and vagina. 

F^g. 152.— Complete prolapse of the uterus, with eversion of vagina (Keen and White). 



with its adnexa ; connected with this uterus was another one, anterior to it. 
The two uteruses had a common cervix ; the anterior of the two organs had 
no adnexa, though there were lateral peritoneal ligaments ; it had become 
pregnant." Hollander explains the anomaly by stating that probably the 
Miillerian ducts or one of them had srrown excessively, leadino' to a foldinsr 
off of a portion which developed into the anterior uterus. 

Other cases of double uterus with pregnancy are mentioned on page 49. 

When there is simultaneous pregnancy in each portion of a double uterus 
a complication of circumstances arises. Debierre quotes an instance of a 
woman who bore one child on July 16, 1<S70, and another on October 31st of 
the same year, and both at full term. She had only had three menstrual periods 
between the confinements. The question as to whether a case like this would 
be one of superfetation in a normal 
uterus, or whether the uterus was 
double, would immediately arise. 
There would also be the possibility 
that one of the children was of pro- 
tracted gestation or that the other was 
of premature birth. Article 312 of 
the Civil Code of France accords a 
minimum of one hundred and eighty 
and a maximum of three hundred 
days for the gestation of a viable 
child. (See Profracfed Gestation.) 

Voight'^ is accredited with having 
seen a triple uterus, and there are 
several older parallels on record. 
Thilow mentions a uterus which was 
divided into three small portions. 

Of the different anomalous positions of the uterus, most of which are 
acquired, the only one that wall be mentioned is that of complete prolapse of 
the uterus (Fig. 152). In this instance the organ may hang entirely out of 
the body and even forl)id locomotion. 

Of 19 cases of hernia of the uterus quoted by Debierre 13 have been ob- 
served in the inguinal region (Fig. 153), five on the right and seven on the left 
side. In the case of Roux in 1891 the hernia existed ok* both sides. The 
uterus has been found twice only in crural hernia and three times in umbilical 
hernia. There is one case recorded, according to Debierre, in which the uterus 
was one of the constituents of an obturator hernia. Sometimes its appendages 
are found with it, Doring, Ledesma, Rektorzick, and Scazoni have found 
the uterus in the sac of an inguinal hernia ; Leotaud, Murray, and Hagner 
in an umbilical hernia. The accompanying illustration (Fig. 154) represents 
a hernia of the gravid womb through the linea alba. 

a 503, iii., 175. 

Fig. 153. — Inguinal hernia containing a gravid womb 



Absence of the penis is an extremely rare anomaly, although it has 
been noted by Schenck," Borellns, Bouteiller, Nelaton, and others. Fortu- 
natus Fidelis '' and Revolat describe a newly born child ^^■ith absence of 
external genitals, with spina bifida and umbilical hernia. N^laton •^ describes 
a child of two entirely without a penis, but both testicles were found in the 
scrotum ; the boy urinated by the rectum. Ashby and Wright ^ mention 
complete absence of the penis, the urethra opening at the margin of the anus 
outside the external sphincter ; the scrotum and testicles were well developed. 
jNIurphy ^ gives the description of a well-formed infant apparently without a 
penis ; the child passed urine through an opening in the lower part of the 
abdomen just above the ordinary location of ihe penis ; the scrotum was 
present. Incisions were made into a small swelling just below the urinary 

Fig. 154. — Hernia of tbe gravid womb through the linea alba. 

opening in the abdomen which brought into view the penis, the glans being 
normal but the body very small. The treatment consisted of pressing out 
the glans daily until the wound healed ; the penis receded spontaneously. It 
is stated that the organ would doubtless be equal to any requirements de- 
manded of it. Demarquay quotes a somewhat similar case in an infant, but 
it had no urinary opening until after operation. 

Among the older writers speaking of deficient or absent penis are Bar- 
tholinus,^^° Bauhinus, Cattierus, the Ephemerides, Frank, Panaroli/^^ van 
der Wiel, and others. Renaiildin ^ describes a man with a small penis and 
enormous mammse. Goschler,^ quoted by Jacobson, sj^eaks of a well-de- 
veloped man of twenty-two, with abundant hair on his chin and suprapubic 

a 718, lib. iv., chap. 9. 

d " Dis. of Children," p. 53. 

'j De relationibus medicorum, uo. 357. c 363, 1854. 

e 224, 1885, ii., 62. f 565, tome i., p. 294. g 808, 1857. 


region and the scrotum apparently perfect, with median raphe ; a careful 
search failed to show any trace of a penis ; on the anterior wall of the' 
rectum four lines above the anus was an oritice which gave vent to urine ; the 
right testicle and cord were normal, but there was an acute orchitis in the 
left. Starting from just in front of the anal orifice was a fold of skin 1| 
inches long and | inch high continuous with the raphe, which seemed to be 
fonned of erectile tissue and which swelled under excitement, the enlarge- 
ment lasting several minutes with usually an emission from the rectum. It 
was possible to pass a sound through the opening in the rectum to the blad- 
der through a urethra 1^ inches wide ; the patient had control of the bladder 
and urinated from every three to five hours. 

Many instances of rudimentary development of the penis have been 
recorded, most of them complicated with cryptorchism or other abnormality 
of the sexual organs. In other instances the organ is present, but the 
infantile type is present all through life ; sometimes the subjects are weak 
in intellect and in a condition similar to cretinism. Kaufmann quotes a case 
in a weakly boy of twelve whose penis was but | inch long, about as thick 
as a goose-quill, and feeling as limp as a mere tube of skin ; the corpora 
cavernosa were not entirely absent, but ran only from the ischium to the 
junction of the fixed portion of the penis, suddenly terminating at this point. 
Nothing indicative of a prostate could be found. The testicles were at the 
entrance of the inguinal canal and the glans was only slightly developed. 

Binef^ speaks of a man of fifty-three whose external genitalia were of 
the size of those of a boy of nine. The penis was of about the size of the 
little finger, and contained on each side testicles not larger than a pea. There 
was no hair on the pubes or the face, giving the man the aspect of an old 
woman. The prostate was almost exterminated and the seminal vesicles were 
very primitive in conformation. Wilson was consulted by a gentleman of 
twenty-six as to his ability to perform the marital function. In size his 
penis and testicles hardly exceeded those of a boy of eight. He had never 
felt desire for sexual intercourse until he became acquainted with his intended 
wife, since when he had erections and nocturnal emissions. The patient 
married and became the father of a family ; those parts which at twenty-six 
were so much smaller than usual had increased at twenty-eight to normal 
adult size. There are three cases on record in the older literature of penises 
extremely primitive in development. They are quoted by \*^he Ephemerides, 
Plater,''^^ Schenck,'' and Zacchias. The result in these cases was impotency. 

In the Army and Medical Museum at Washington are two injected speci- 
mens of the male organ divested of skin. From the meatus to the pubis 
they measure 6| and 5| inches ; from the extremity to the termination of 
either crus 9| and 8f inches, and the circumferences are 4| and 4\ inches. 
Between these two we can strike an average of the size of the normal penis. 

a 242, 1883. b 718, lib. iv., obs. 12. 


Ill some instances the penis is so large as to forbid coitus and even inconveni- 
ence its possessor, measuring as much as ten or even more inches in length. 
Extraordinary cases of large penis are reported by Albinus ^^^(who mentions 
it as a cause for sterility), Bartholinus,^^-' Fabricius Hildanus, Paullini, Peyer, 
Plater, Schurig, " Sinibaldus,' " and Zacchias. Several cases of enormous 
peuises in the new-born have been observed by WoliF^' and others.^' 

The penis palme, or .mture de la verge of the French, is the name given 
to those examples of single cutaneous envelope for both the testicles and 
penis ; the penis is adherent to the scrotum by its inferior face ; the glans only 
is free and erection is impossible. Chretien cites an instance in a man of 
twenty-five, and Schrumpf of Wesserling ^ describes an example of this rare 
anomaly. The penis and testes were inclosed in a common sac, a slight pro- 
jection not over ^ inch long being seen from the upper part of this curious 
scrotum. When the child was a year old a plastic operation was performed 
on this anomalous member with a very satisfactory result. Petit describes 
an instance in which the penis was slightly fused with the scrotum. 

There are many varieties of torsion of the penis. The glans itself may 
be inclined laterally, the curvature may be total, or there may be a veritable 
rotation, bringing the inferior face above and the superior face below. Gay ® 
describes a child with epispadias whose penis had undergone such torsion on 
its axis that its inferior surface looked upward to the left, and the child 
passed urine toward the left shoulder. Follin ^ mentions a similar instance 
in a boy of twelve with complete epispadias, and Verneuil and Guerlin 
also record cases, both complicated with associate maldevelopment. Caddy s 
mentions a youth of eighteen who had congenital torsion of the penis with- 
out hypospadias or epispadias. There was a complete half-turn to the left, so 
that the slit-like urinary meatus Avas reversed and the frenum was above. 
Among the older writers who describe incurvation or torsion of the penis 
are Arantius,'' the Ephemerides, Haenel,'*'^^ Petit,' Schurig, Tulpius,' and 

Zacutus Lusitanus ^ speaks of torsion of the penis from freezing. Paul- 
lini ^ mentions a case the result of masturbation, and Hunter ■" speaks of 
torsion of the penis associated with arthritis. 

Ossification of the Penis. — MacClellan " speaks of a man of fifty-two 
whose penis was curved and distorted in such a manner that urine could not 
be passed without pain and coitus Was impossible. A bony mass was dis- 
covered in the septum between the corpora cavernosa ; this was, dissected out 
with much hemorrhage and the upward curvature was removed, but there 

a " Sperraatologia, " p. 109. b " Lect. Memorab.," tome i., p. 34. 

c " Memoires concernant les Arts," 1672, 27. d 369, 1882. e 779, xvi., 189. 

f 789, 1862. g 476, Sept. 15, 1894. b 718, L. iv., no. 14. 

i 625, Supplement. J 842, L. iii., no. 39. ^831, L. iii., obs. 118. 

1 620, cent, iv., ob.s. 92. m " References on Venereal Diseases," etc. 

D Nouveau Journal des Sciences Medicales, March, 1878. 


resulted a slight inclination in the opposite direction. The formation of bone 
and cartikige in the penis is quite rare. Velpeau, Kautfmann, Lenhoseck, 
and Duploy are quoted by Jacobson as having seen this anomaly. There is 
an excellent preparation in Vienna figured by Demarquay, but no description 
is given. The Ephemerides and Paullini =^ describe osseous penises. 

The complete absence of the frenum and prepuce has been observed 
in animals but is very rare in man. The incomplete or irregular develop- 
ment is more frequent, but most common is excessive development of the pre- 
puce, constituting phimosis, when there is abnormal adherence with the glans. 
Instances of phimosis, being quite common, will be passed without special 
mention. Deficient or absent prepuce has been observed by Blasius,^^^ Mar- 
cellus Donatus,^**^ and Gilibert. Partial deficiency is described by Petit, 
Severinus, and others. 

There may be imperforation or congenital occlusion of some portion of the 
urethra, causing enormous accumulation of urine in the bladder, but fortu- 
nately there is generall}' in such cases some anomalous opening of the ure- 
thra giving vent to the excretions. Tulpius '^ mentions a case of deficient 
urethra. In the Ephemerides there is an account of a man who had a con- 
stant flow of semen from an abnormal opening in the abdomen. La Pey- 
ronia '^ describes a case of impotence due to ejaculation of the spermatic ducts 
into the bladder instead of into the urethra, but remarks that there was a 
cicatrix of a wound of the neighboring parts. There are a number of 
instances in which the urethra has terminated in the rectum. Congenital 
dilatation of the urethral canal is very rare, and generally accompanied by 
other malformation. 

Duplication of the urethra or the existence of two permeable canals is 
not accepted by all the authors, some of whom contend that one of the canals 
either terminates in a culdesac or is not separate *iu itself. Verneuil has pub- 
lished an article clearly exposing a number of cases, showing that it is possi- 
ble for the urethra to have two or more canals which are distinct and have 
separate functions. Fabricius Hildanus '^ speaks of a double aperture to the 
urethra ; Marcellus Donatus ^ describes duplicity of the urethra, one of the 
apertures being in the testicle ; and there is another case on record ^ in which 
there was a urethral aperture in the groin. A case of double urethra in a 
man of twenty-five living in Styria ^ who was vinder treatment for gonorrhea 
is described, the supernumerary urethra opening above the natural one and 
receiving a sound to the depth of 17 cm. There was purulent gonorrhea in 
both urethrse. Vesalius ^ has an account of a double urethral aperture, one of 
which was supposed to give spermatic fluid and the other urine. Borellus, 
Testa, and Cruveilhier have reported similar instances. Instances of double 
penis have been discussed under the head of diphallic terata, page 194. 

a 620, cent, i, obs. 72. b 842, L. xliv., cap. 36. c 563, i., 427. 

d334, cent, i., obs. 76. e 306, L. vi., c. ii., 619. f 524, vol. ii., 440. 

g 536, 18«7, vol. ii. b 804, L. v., c. 18. 



Hypospadias and epispadias (Fig. 155) are names given to malforma- 
tions of the urethra in whieh the wall of the canal is deficient either above 
or below. These anomalies are jwrticularly interesting, as they are nearly 
always found in male hermaplirodites, the fissure giving the appearance of a 
vulva, as the scrotum is sometimes included, and even the perineum may be 
fissured in. continuity with the other parts, thus exaggerating the deception. 
There seems to be an element of heredity in this malformation, and this 
allegation is exemplified by Sedgwick, who quotes a case from Heuremaun in 
which a family of females had for generations given birth to males with 
hypospadias. Belloc'' mentions a man whose urethra terminated at the base 
of the frenum who had four sons with the same deformity. Picardat ^' men- 
tions a father and son, both of whom 
had double urethral orifices, one above 
the other, from one of which issued 
urine and from the other semen — 
a fact that shows the possibility of 
inheritance of this malformation. 
Patients in whom the urethra opens 
at the root of the penis, the meatus 
being imperforate, are not necessarily 
impotent ; as, for instance, Fournier '^ 
knew of a man whose urethra opened 
posteriorly who was the father of four 
children. Fournier supposed that 
the semen ejaculated vigorously and 
followed the fissure on the back of the 
penis to the uterus, the membrane 
of the vagina supplanting the deficient 
wall of the urethra. The penis was 
short, but about as thick as ordinary. 
Gray '^ mentions a curious case in a man afflicted with hypospadias who, 
suffering wdth delusions, was confined in the insane asylum at Utica. AVhen 
he determined to get married, fully appreciating his physical defect, he re- 
solved to imitate nature, and being of a very ingenious turn of mind, he 
busied himself with the construction of an artificial penis. AVhile so en- 
gaged he had seized every opportunity to study the conformation of this 
organ, and finally prepared a body formed of cotton, six inches in length, and 
shaped like a penis, minus a prepuce. He sheathed it in pig's gut and gave 
it a slight vermilion hue. To the touch it felt elastic, and its shape was 
maintained by a piece of gutta-percha tubing, around which the cotton was 
firmly wound. It was fastened to the waist-band by means of straps, a cen- 
tral and an upper one being so arranged that the penis could be thrown into 
a 302, xxiv. l^ These de Paris, 1858, No. 91. c 302, iv., 162. ^ 773, 1870 

Fig. 155.— Complete epispadias. 


an erect position and so maintained. He had constrneted a flesh-colored cov- 
ering which completely concealed the straps. With this artificial member he. 
was enabled to deceive his wife for fifteen months, and was only discovered when 
she undressed him while he was in a state of intoxication. To further the 
deception he had told his wife immediately after their marriage that it 
was quite indecent for a husband to undress in the presence of his wife, and 
therefore she had always retired first and turned out the light. Partly from 
fear that his virile power would be questioned and partly from ignorance, 
the duration of actual coitus would approach an hour. When the discovery 
was made, his wife hid the instrument with which he had perpetrated a most 
successful fraud upon her, and the patient subsequently attempted coitus by 
contact with unsuccessful results, although both parties had incomplete 
orgasms. Shortly afterward evidences of mental derangement appeared and 
the man became the subject of exalted delusions. His wife, at the time 
of report, had filed application for divorce. Haslam " reports a case in which 
loss of the penis was compensated for by the use of an ivory succedaneum. 
Parallel instances of this kind have been recorded by Ammann '' and 

Entire absence of the male sexual apparatus is extremely rare, but 
Blondin and Velpoau have rei)orted cases. 

Complete absence of the testicles, or anorchism, is a comparatively rare 
anomaly, and it is very difficult to distinguish between anorchism and arrest 
of development, or simple atrophy, which is much more common. Fisher of 
Boston*^ describes the case of a man of forty-five, who died of pneumonia. 
From the age of puberty to twenty-five, and even to the day of death, his 
voice had never changed and his manners were decidedly eifeminate. He 
always sang soprano in concert with females. After the age of twenty-five, 
however, his voice became more grave and he could not accompany females 
with such ease. He had no beard, had never shaved, and had never exhibited 
amorous propensities or desire for female society. When about twenty-one 
he became associated with a gay company of men and was addicted to the 
cup, but would never visit houses of ill-fame. On dissection no trace of 
testicles could be found ; the scrotum was soft and flabby. The cerebellum 
was the exact size of that of a female child. 

Individuals with one testicle are called monorchids, and may be divided 
into three varieties : — 

(1) A solitary testicle divided in the middle by a deep fissure, the two 
lobes being each provided with a spermatic cord on the same side as the lobe. 

(2) Testicles of the same origin, but with coalescence more general. 

(3) A single testicle and two cords. 

Gruber of St. Petersburg ^ held a postmortem on a man in Januar}^, 

a 476, 1828, ii., 182. b " ireuicum Numje," p. 133. c 445^ p. 406. 

d 124, Feb., 1839. e 553, Heft i., 1868. 


1867, in whom the right half of the scrotum, the right testicle, epididymis, 
and the scrotal and inguinal parts of the right vas deferens were absent. 
Gruber examined the literature for thirty years up to the time of his report, 
and found 30 recorded postmortem exa^ninations in which there was absence 
of the testicle, and in eight of these l)oth testicles were missing. As a rule, 
natural eunuchs have feeble bodies, are mentally dull, and live only a short time. 
The penis is ordinarily defective and there is sometimes another associate mal- 
formation. They are not ahvays disinclined toward the opposite sex. 

Polyorchids are persons who have more than two testicles. For a long 
time the abnormality was not believed to exist, and some of the observers 
denied the proof by postmortem examination of any of the cases so diagnosed ; 
but there is at present no doubt of the fact, — three, four, and five testicles 
having been found at autopsies. Russell, one of the older writers on the 
testicle, mentions a monk who was a triorchid, and was so salacious that his 
indomitable passion prevented him from keeping his vows of chastity. The 
amorous propensities and generative faculties of polyorchids have always been 
supposed greater than ordinary. Russell reports another case of a man with 
a similar peculiarity, who was prescribed a concubine as a reasonable allow- 
ance to a man thus endowed. 

Morgagni and Meckel say that they never discovered a third testicle in 
dissections of reputed triorchids, and though Haller " has collected records of 
a great number of triorchids, he has never been able to verify the presence 
of the third testicle on dissection. Some authors, including Haller, have 
demonstrated heredity in examples of polyorchism. There is an old instance ^ 
in which two testicles, one above the other, were found on the right side and 
one on the left. Macann ° describes a recruit of twenty, whose scrotum seemed 
to be much larger on the right than on the left side, although it was not 
pendulous. On dissection a right and left testicle were found in their normal 
positions, but situated on the right side between the groin and the normal 
testicle was a supernumerary organ, not in contact, and having a separate and 
short cord. Prankard ^ also describes a man with three testicles. Three cases 
of triorchidism were found in recruits in the British Army.*^ Lane^ reports a 
supernumerary testis found in the right half of the scrotum of a boy of fifteen. 
In a necropsy held on a man killed in battle, Hohlberg ^ discovered three fully 
developed testicles, two on the right side placed one above the other. The 
London Medical Record of 1884 quotes JdanofF of St. Petersburg in men- 
tioning a soldier of twenty-one who had a supernumerary testicle erroneously 
diagnosed as inguinal hernia. Quoted by the same reference, BulatoH' men- 
tions a soldier who had a third testicle, which diagnosis was confirmed by 
several of his confreres. They recommended dismissal of the man from the 
service, as the third testicle, usually resting in some portion of the inguinal 
canal, caused extra exposure to traiunatic influence. 

a 40n, L. xxvii., 412. b 504, xviii., 362. c 656, 1842. d 654, 1842. 
e 47G, 1865, ii., 501. f 224, Dec. 1, 1894. g 812, 1882, 38, 642. 


Venette'' gives an instance of four testicles, and Scharif, in the Ephe- 
merides, mentions five ; Blasius '-^^ mentions more than three testicles, and, 
without citing proof, Buifon admits the possibility of such occurrence and 
adds that such men are generally more vigorous. 

Russell'^ mentions four, five, and even six testicles in one individual; 
all were not verified on dissection. He cites an instance of six testicles, 
four of which were of usual size and two smaller than ordinary. 

Baillie, the Ephemerides, and Schurig mention fusion of the testicles, 
or synorchidism, somewhat after the manner of the normal disposition of the 
batrachians and also the kangaroos, in the former of which the fusion is ab- 
dominal and in the latter scrotal. Kerckring ^ has a description of an indi- 
vidual in whom the scrotum was absent. 

In those cases in which the testicles are still in the abdominal cavity 
the individuals are termed cryptorchids. Johnson '^ has collected the re- 
sults of postmortem examinations of 89 supposed cryptorchids. In eight of this 
number no testicles were found postmortem, the number found in the abdomen 
was uncertain, l^ut in 18 instances both testicles were found in the inguinal 
canal, and in eight only one was found in the inguinal canal, the other not 
appearing. The number in which the semen was examined microscopically 
was 16, and in three spermatozoa were found in the semen ; one case was 
dubious, spermatozoa being found two weeks afterward on a boy's shirt. 
The number having children was ten. In one case a monorchid generated a 
crvptorchid child. Some of the cryptorchids were effeminate, although 
others were manly with good evidences of a beard. The morbid, hypochon- 
driac, the voluptuous, and the imbecile all found a place in Johnson's statis- 
tics ; and although there are evidences of the possession of the generative 
function, still, we are compelled to say that the chances are against fecundity 
of human cryptorchids. In this connection might be quoted the curious case 
mentioned by Geoffroy-Saint-Hilaire, of a soldier who was hung for rape. It 
was alleged that no traces of testicles were found externally or internally, 
yet semen containing spermatozoa was found in the seminal vesicles. Sper- 
matozoa have been found days and weeks after castration, and the individuals 
during this period were capable of impregnation, but in these cases the reser- 
voirs were not empty, although the spring had ceased to flow. Beigel, in 
Virchow's Archives, mentions a crvptorchid of twenty-two who had noctur- 
nal emissions containing spermatozoa and who indulged in sexual congress. 
Partridge ^ describes a man of twenty-four who, notwithstanding his condi- 
tion, gave evidences of virile seminal flow. 

In some cases there is anomalous position of the testicle. Hough ^ 
mentions an instance in wliich, from the great pain and sudden appearance, a 
small tumor lying against the right pubic bone was supposed to be a strangu- 

a 215, au. ii., 38. b " Qbs. on Testicles," Edinburgh, 1833. c 473, obs. xii. 

d775, 1884. e 476, I860, i., 66. ^ 545, 1884. 



lated hernia. There were two well-developed testicles in the scrotum, and the 
hernia proved to be a third. McElmail ^ describes a soldier of twenty-nine, 
who two or three months before examination felt a pricking and slight burn- 
ing pain near the internal aperture of the internal inguinal canal, succeeded 
by a swelling until the tumor passed into the scrotum. It was found in 
the upper part of the scrotum above the original testicle, but not in contact, 
and was about half the size of the normal testicle ; its cord and epididymis 
could be distinctly felt and caused the same sensation as pressure on the other 
testicle did. 

Marshall '' mentions a boy of sixteen in whom the right half of the 
scrotum was empty, although the left was of normal size and contained a 
testicle. On close examination another testicle was found in the perineum ; 
the boy said that while running he fell down, four years before, and on get- 
ting up suffered great pain in the groin and this pain recurred after exertion. 
This testicle was removed successfully to the scrotum. Horsley collected 20 
instances of operators who made a similar attempt, Annandale being the 
first one ; his success was likely due to antisepsis, as previously the testicles 
had always sloughed. There is a record of a dog remarkable for its salacity 
who had two testicles in the scrotum and one in the abdomen ; some of the 
older authors often indulged in playful humor on this subject. 

Brown *^ describes a child with a swelling in the perineum both painful 
and elastic to the touch. The child cried if pressure was applied to the 
tumor and there was every evidence that the tumor was a testicle. Hutche- 
son, quoted by Russell,'^ has given a curious case in an English seaman who, 
as was the custom at that time, v/as impressed into service by H. INI. S. 
Druid in 1807 from a trading ship off the coast of Africa. The man said 
he had been examined by dozens of ship-surgeons, but was invariably re- 
jected on account of rupture in both groins. The scrotum was found to be 
an empty bag, and close examination showed that the testicles occupied the 
seats of the supposed rupture. As soon as the discovery was made the man 
became unnerved and agitated, and on re-examining the parts the testicles 
were found in the scrotum. When he found that there was no chance for 
escape he acknowledged that he was an impostor and gave an exhibition in 
which, with incredible facility, he pulled both testes up from the bottom of 
the scrotum to the external abdominal ring. At the word of command he 
could pull up one testicle, then another, and let them drop simultaneously ; he 
performed other like feats so rapidly that the movements qpuld not be dis- 

In this connection Russell speaks of a man whose testicle was elevated 
every time the east wind blew, which caused him a sense of languor and re- 

•1 523, 1856, ix., 91. ^ 548, 1883. 

c 436, 1891, ii., 546. d "Obs. on Testicles." Ediub., 1833. 


laxation ; the same author describes a man whose testicles ascended into the 
ino;iiinal canal every time he was in the company of women. 

Inversion of the testicle is of several varieties and quite rare ; it has 
been recognized by Sir Astley Cooper, Boyer, Maisonneuve, Royet, and 
other writers. 

The anomalies of the vas deferens and seminal vesicles are of little in- 
terest and will be passed with mention of the case of Weber,^ who found 
the seminal vesicles double ; a similar conformation has been seen in 

a 559, May, 1811, 88. 



Giants. — The fables of mythology contain accounts of horrible monsters, 
terrible in ferocity, whose mission was the destruction of the life of the in- 
dividuals unfortunate enough to come into their domains. The ogres known 
as the Cyclops, and the fierce anthropophages, called Lestrygons, of Sicily, who 
were neighbors of the Cyclops, are pictured in detail in the " Odyssey " of 
Homer. Nearly all the nations of the earth have their fairy tales or super- 
stitions of monstrous beings inhabiting some forest, mountain, or cave ; and 
pages have been written in the heroic poems of all languages describing battles 
between these monsters and men with superhuman courage, in which the giant 
finally succumbs. 

The v.ord giant is derived indirectly from the old English word " geant," 
which in its turn came from the French of the conquering Normans. It 
is of Greek derivation, " yiya-': " — or the Latin, " gigas." The Hebrew 
parallel is " nophel," or plural, " nephilim." 

Ancient Giants. — We are told in the Bible ^ that the bedstead of Og, 
King of Basham, was 9 cubits long, which in English measure is 16 J feet. 
Goliath of Gath, who was slain by David, stood 6 cubits and a span tall — 
about 11 feet. The body of Orestes, according to the Greeks, was 1\^ feet 
long. The mythical Titans, 45 in number, were a race of Giants who warred 
against the Gods, and their descendants were the Gigantes. The height 
attributed to these creatures was fabulous, and they were supposed to heap up 
mountains to scale the sky and to help them to wage their battles. Hercules, 
a man of incredible strength, but who is said to have been not over 7 feet 
high, was dispatched against the Gigantes. 

Pliny describes Gabbaras, who was brought to Rome by Claudius Caesar 
from Arabia and was between 9 and 10 feet in height, and adds that the re- 
mains of Posio and Secundilla, found in the reign of Augustus Csesar in the 
Sallustian Gardens, of which they were supposed to be the guardians, meas- 
ured 10 feet 3 inches each. In common with Augustine, Pliny believed that 
the stature of man has degenerated, but from the remains of the ancients so 
far discovered it would appear that the modern stature is about the same as 

a Deuteronomy iii., 11. 


the ancient. The beautiful alabaster sarcophagus discovered near Thebes in 
1817 and now in Sir John Soane's Museum in Lincoln's Inn Fields in 
London measures 9 feet 4 inches long. This unique example, the finest 
extant, is well worth inspection by visitors in London. 

Herodotus says the shoes of Perseus measured an equivalent of about 3 
feet, English standard. Josephus tells of Eleazar, a Jew, among the hostages 
sent by the King of Persia to Rome, who was nearly 1 1 feet high. Saxo, the 
grammarian, mentions a giant 13| feet high and says he had 12 companions 
who were double his height. Ferragus, the monster supposed to have been 
slain by Roland, the nephew of Charlemagne, was said to have been nearly 
1 1 feet high. It was said that there was a giant living in the twelfth century 
under the rule of King Eugene II. of Scotland who was 11 1 feet high. 

There are fabulous stories told of the Emperor Maximilian. Some 
accounts say that he was between 8| and 9 feet high, and used his wife's 
bracelet for a finger-ring, and that he ate 40 pounds of flesh a day and drank 
six gallons of wine. He was also accredited with being a great runner, and in 
his earlier days was said to have conquered single-handed eight soldiers. 
The Emperors Charlemagne and*Jovianus were also accredited with great 
height and strength. 

In the olden times there were extraordinary stories of the giants who 
lived in Patagonia. Some say that Magellan gave the name to this country 
because its inhabitants measured 5 cubits. The naturalist Turner says that 
on the river Plata near the Brazilian coast he saw naked savages 1 2 feet 
high ; and in his description of America, Thevenot confirms this by saying 
that on the coast of Africa he saw on a boat the skeleton of an American 
giant who had died in 1559, and who was 11 feet 5 inches in height. He 
claims to have measured the bones himself. He says that the bones of the 
leg measured 3 feet 4 inches, and the skull was 3 feet and 1 inch, just about 
the size of the skull of Borghini, who, however, was only of ordinary height. 
In his account of a voyage to the Straits of Magellan, Jacob Lemaire says 
that on December 17, 1615, he found at Port Desire several graves covered 
with stones, and beneath the stones were skeletons of men which measured 
between 10 and 11 feet. The ancient idea of the Spaniards was that the 
men of Patagonia were so tall that the Spanish soldiers could pass under 
their arms held out straight ; yet we know that the Patagonians exhibit no 
exasro-eration of height — in fact, some of the inhabitants about Terra del 
Fuego are rather diminutive. This superstition of the voyagers was not 
limited to America ; there were accounts of men in the neighborhood of the 
Peak of Teneriffe who had 80 teeth in their head and bodies 15 feet in 

Discoveries of "Giants' Bones." — Riolan,*'^^ the celebrated anatomist, 
says that there was to be seen at one time in the suburbs of Saint Germain 
the tomb of the giant Isoret, who was reputed to be 20 feet tall ; and that in 


1509, in digging ditches at Rouen, near the Dominicans, they found a stone 
tomb containing a monstrous skeleton, the skull of which would hold a bushel 
of corn ; the shin-bone measured about 4 feet, which, taken as a guide, would 
make his height over 17 feet. On the tomb was a copper plate which said 
that the tomb contained the remains of " the noble and puissant lord, the 
Chevalier Ricon de Vallemont." Plater,^^^ the famous physician, declares 
^ that he saw at Lucerne the true human bones of a subject that must have 
/ been at least 19 feet high. 

Valence in Daujjhine boasted of possessing the bones of the giant Bucart, 
the tyrant of the Yivarias, who was slain by his vassal. Count de Cabillon. 
The Dominicans had the shin-bone and part of the knee-articulation, which, 
substantiated by the frescoes and inscriptions in their possession, showed him 
to be 22J feet high. They claimed to have an os frontis in the medical 
school of Ley den measuring 9.1 X 12.2 X .5 inches, which they deduce 
must have belonged to a man 11 or 12 feet high. 

It is said that while digging in France in 1613 there was disinterred the 
body of a giant bearing the title *' Theutobochus Rex," and that the skeleton 
measured 25 feet long, 10 feet across the shoulders, and 5 feet from breast 
to back. The shin-bone was about 4 feet long, and the teeth as large 
as those of oxen. This is likely another version of the finding of the 
remains of Bucart. 
« Near Mezarino in Sicily in 1516 there was found the skeleton of a giant 

whose height was at least 30 feet ; his head was the size of a hogshead, and 
each tooth w^eighed 5 ounces; and in 1548 and in 1550 there were others 
found of the height of 30 feet. The Athenians found near their city skele- 
tons measuring 34 and 36 feet in height. In Bohemia in 758 it is recorded 
that there was found a human skeleton 26 feet tall, and the leg-bones are still 
kept in a medieval castle in that country. In September, 1691, there was 
the skull of a giant found in Macedonia wdiich held 210 pounds of corn. 

General Opinions. — All the accounts of giants originating in the finding 
of monstrous bones must of course be discredited, as the remains were likely 
those of some animal. Comparative anatomy has only lately obtained a hold 
in the public mind, and in the Middle Ages little was known of it. The pre- 
tended giants' remains have been those of mastodons, elephants, and other 
animals. From Suetonius we learn that Augustus Caesar pleased himself 
by adorning his palaces with so-called giants' bones of incredible size, prefer- 
ring these to pictures or images. From their enormous size we must be- 
lieve they were mastodon bones, as no contemporary animals show such 
measurements. Bartholinus ^ describes a large tooth for many years exhib- 
ited as the canine of a giant which proved to be nothing but a tooth of a 
spermaceti whale (Cetus dentatus), quite a common fish. Hand '^ described 
an alleged giant's skeleton shown in London early in the eighteenth century, 

a 190, cent, i., hist. 98. b G29, No. 168. 


and which was composed of the boues of the fore-fin of a small whale or of 
a porpoise. 

The celebrated Sir Hans Sloane, who treated this subject very learnedly, 
arrived at the conclusion that while in most instances the bones found were 
those of mastodons, elephants, whales, etc., in some instances accounts were 
given by connoisseurs who could not readily be deceived. However, modern 
scientists will be loath to believe that any men ever existed who measured 
over 9 feet ; in fact, such cases with authentic references are extremely rare. 
Quetelet considers that the tallest man whose stature is authentically recorded AX 
was the " Scottish Giant " of Frederick the Great's regiment of giants. This 
person was not quite 8 feet 3 inches tall. Buifon, ordinarily a reliable au- 
thority, comes to a loose conclusion that there is no doubt that men have 
lived who were 10, 12, and even 15 feet tall ; but modern statisticians can- 
not accept this deduction from the references offered. 

From the original estimation of the height of Adam (Henrion once calcu- IX 
lated that Adam's height was 123 feet and that of Eve 118) we gradually 
come to 10 feet, which seemed to be about the favorite height for giants in 
the Middle Ages. Approaching this century,we still have stories of men from 
9 to 10 feet high, but no authentic cases. It was only in the latter part of 
the last century that we began to have absolutely authentic heights of giants, 
and to-day the men showing through the country as measuring 8 feet 
generally exaggerate their height several inches, and exact measurement 
would show that but few men commonly called giants are over 7 J feet or 
weigh over 350 pounds. Dana'^ says that the number of giants figuring as 
public characters since 1700 is not more than 100, and of these about 20 
were advertised to be over 8 feet. If we confine ourselves to those ac- 
curately and scientifically measured the list is surprisingly small. Topinard 
measured the tallest man in the Austrian army and found that he was 8 feet 
41 inches. The giant Winckelmeyer measured 8 feet 6 inches in height. 
Ranke measured Marianne AVehde, who was born in Germany in the present 
century, and found that she measured 8 feet 4 J inches when only sixteen and 
a half years old. 

In giants, as a rule, the great stature is due to excessive growth of the 
lower extremities, the size of the head and that of the trunk l^eing nearly 
the same as those of a man or boy of the same age. On the other hand, in 
a natural dwarf the proportions are fairly uniform, the head, however, being 
always larger in proportion to the body, just as we find in infants. Indeed, 
the proportions of " General Tom Thumb " were those of an ordinary infant 
of from thirteen to fifteen months old. 

Figure 156 shows a portrait of two well-known exhibitionists of about the 
same age, and illustrates the possible extremes of anomalies in stature. 

Recently, the association of acromegaly with gigantism has been 

a 723, Feb., 1895. 


noticed, and in these instances there seems to be an acquired uniform enlarge- 
ment of all the bones of the body, Brissaud and Meige'* describe the case of a 
male of fortv-seven who presented nothing unusual before the age of sixteen, 
when he began to grow larger, until, having readied his majority, he measured 7 
feet 2 inches in height and weighed about 340 pounds. He remained well and 
very strong until the age of thirty-seven, when he overlifted, and following this 
he developed an extreme deformity of the spine and trunk, the latter " tele- 
scoping into itself" until the nipples were on a level with the anterior superior 
spines of the ilium. For two years he suffered with debility, fatigue, bron- 
chitis, night-sweats, head- 
ache, and great thirst. 
Mentally he was dull ; 
the bones of the face and 
extremities showed the 
hypertrophies character- 
istic of acromegaly, the 
soft parts not being in- 
volved. The circumfer- 
ence of the trunk at the 
nipples was 62 inches, 
and over the most promi- 
nent portion of the ky- 
phosis and pigeon-breast, 
74 inches. The authors 
agree with Dana and 
others that there is an 
intimate relation between 
acromegaly and gigan- 
tism, but they go further 
and compare both to the 
growth of the body. They 
call attention to the strik- 
ing resemblance to acromegaly of the disproportionate growth of the boy at 
adolescence, which corresponds so well to Marie's terse description of this 
disease : " The disease manifests itself by preference in the bones of the 
extremities and in the extremities of the bones," and conclude with this 
rather striking and aphoristic proposition : '' Acromegaly is gigantism of the 
adult ; gigantism is acromegaly of adolescence." 

The many theories of the cause of gigantism will not be discussed here, 
the reader being referred to volumes exclusively devoted to this subject. 

Celebrated Giants. — Mention of some of the most flimous giants will 
be made, together with any associate points of interest. 

a Jour, de Med. et de Chir. prat., Jan. 25, 1895. 

Fig. 156.— Giantess and ilwarf of the same age. 


Becanus, physician to Charles Y., says that he saw a youth 9 feet high 
and a man and a woman ahnost 10 feet. Ainsworth says that in 1553 the 
Tower of London was guarded by three brothers claiming direct descent 
from Henry YIII., and surnamed Og, Gog, and Magog, all of whom were 
over 8 feet in height. In his '' Chronicles of Holland" in 1557 Hadrianus 
Barlandus said that in the time of John, Earl of Holland, the giant Nicho- 
las was so large that men could stand under his arms, and his shoe held 3 
ordinary feet. Among the yeoman of the guard of John Frederick, Duke 
of Hanover, there was one Christopher ]\Iunster, 8| feet high, who died in 
1676 in his forty-fifth year. The giant porter of the Duke of Wiirtemberg 
was 7| feet high. " Big Sam," the porter at Carleton Palace, when George 
IV. was Prince of Wales, was 8 feet high. The porter of Queen Elizabeth, 
of whom there is a picture in Hampton Court, painted by Zucchero, was 1^ 
feet high ; and Walter Parson, porter to James I,, was about the same height. 
William Evans, who served Charles I., was nearly 8 feet ; he carried a 
dwarf in his pocket. 

In the seventeenth century, in order to gratify the Empress of Austria, Guy- 
Patin made a congress of all the giants and dwarfs in the Germanic Empire. 
A peculiarity of this congress was that the giants complained to the authorities 
that the dwarfs teased them in such a manner as to make their lives miserable. 

Plater speaks of a girl in Basle, Switzerland, five years old, whose body 
was as large as that of a full-grown woman and who weighed when a year 
old as much as a bushel of wheat. He also mentions a man living in 1613, 
9 feet high, whose hand was 1 foot 6 inches long. Peter van den Broecke 
speaks of a Congo negro in 1640 who was 8 feet high. Daniel, the porter 
of Cromwell, was 7 feet 6 inches high ; he became a lunatic. 

Frazier speaks of Chilian giants 9 feet tall. There is a chronicle which 
says one of the Kings of Norway was 8 feet high. Merula says that in 
1538 he saw in France a Flemish man over 9 feet. Keysler mentions see- 
ing Hans Bran in Tyrol in 1550, and says that he was nearly 12 feet high. 

Jonston ^^ mentions a lad in Holland who was 8 feet tall. Pasumot ^ 
mentions a giant of 8 feet. 

Edmund Mallone was said to have measured 7 feet 7 inches. Wierski, a 
Polander, presented to Maximilian II., was 8 feet high. At the age of 
thirty-two there died in 1798 a clerk of the Bank of England who was said 
to have been nearly Ih feet high. The Daily Advertiser for February 
23, 1745, says that there was a young colossus exhibited opposite the Man- 
sion House in London who was 7 feet high, although but fifteen years old. 
In the same paper on January 31, 1753, is an account of MacGrath, whose 
skeleton is still preserved in Dublin. In the reign of George I., during the 
time of the Bcirtholomew Fair at Smithfield, there was exhibited an English- 
man seventeen years old who was 8 feet tall. 

a " Voyages physiques dans les Pyreuees." 


Xicephorus tells of Antonius of Syria, in the reign of Theodosius, 
who died at the age of twenty-five with a height of 7 feet 7 inches. 
Artacsecas, in great favor with Xerxes, was the tallest Persian and 
measured 7 feet. John Middleton, born in 1752 at Hale, Lancashire, 
hiunorously called the " Child of Hale," and whose portrait is in Brasenose 
College, Oxford, measured 9 feet 3 inches tall. In his " History of Kipton," 
in Devonshire, 1854, Bigsby gives an account of a discoverv in 1687 
of a skeleton 9 feet long. In 1712 in a village in Holland there died a 
fisherman named Gerrit Bastiaansen who was 8 leet high and weighed 500 

pounds. During Queen Anne's reign there was 
shown in London and other parts of England a 
most peculiar anomaly — a German giantess A\ithout 
hands or feet who threaded a needle, cut gloves, 
etc. About 1821 there was issued an engraving 
of ^liss Angelina Melius, nineteen years of age and 

7 feet high, attended by her page, Seiior Don San- 
tiago de los Santos, from the Island of Manilla, 
thirt^'-five years old and 2 feet 2 ' inches high. 
" The Annual Register " records the death of Peter 
Tuchan at Posen on June 18, 1825, of dropsy of 1/ 
the chest. He was twenty-nine years old and 8 
feet 7 inches in height ; he began to grow at the 
age of seven. This monster had no beard ; his 
voice was soft ; he was a moderate eater. There 
was a giant exhibited in St. Petersburg, June, 1829, 

8 feet 8 inches in height, who was very thin and 

Dr. Adam Clarke, who died in 1832, measured 
a man 8 feet 6 inches tall. Frank Buckland, in his 
" Curiosities of Natural History," says that Brice, 
the French giant, was 7 feet 7 inches. Early in 
1837 there was exhibited at Parma a young man 
formerly in the service of the King of the Xether- 
lands who was 8 feet 10 inches high and weighed 
401 pounds. Robert Hale, the " Norfolk Giant," who died in Yarmouth 
in 1843 at the age of forty-three, was 7 feet 6 inches high and weighed 452 
pounds. The skeleton of Cornelius McGrath, now preserved ki the Trinity 
College Museum, Dublin, is a striking example of gigantism. At sixteen 
years he measured 7 feet 10 inches. 

O'Brien or Byrne, the Irish giant, was supposed to be 8 feet 4 inches 
in height at the time of his death in 1783 at the age of twenty-two. The 
stor}' of his connection with the illustrious John Hunter is quite interesting. 
Hunter had vowed that he would have the skeleton of O'Brien, and O'Brien 

Fig. 157.— Skeleton of the 
" Irish Giant " in the Royal Col- 
lege of Surgeons, London. 



was equally averse to being boiled iu the distinguished scientist's kettle. 
The giant was tormented all his life by the constant assertions of Hunter 
and bv his persistence in locating him. Finally, when, following the usual 
earlv decline of his class of anomalies, O'Brien came to his death-bed, he 
bribed some fishermen to take his body after his death to the middle of the 
Irish Channel and sink it with leaden weights. Hunter, it is alleged, was 
informed of this and overbribed the prospective undertakers and thus secured 
the body. It has been estimated that it cost Hunter nearly 500 pounds 
sterling to gain possession of the skeleton 
of the " Irish Giant." The kettle in which 
the body was boiled, together with some 
interesting literature relative to the cir- 
cumstances, are preserved in the Museum 
of the Royal College of Surgeons in Lon- 
don, and were exhibited at the meeting 
of the British ISIedical Association in 
1895 with other Hunterian relics. The 
skeleton, which is now one of the feat- 
ures of the Musemn, is reported to meas- 
ure 92f inches in height, and is mounted 
alongside that of Caroline Crachami, the 
Sicilian dwarf, who was exhibited as an 
Italian princess in London in 1824. She 
did not grow after birth and died at the 
age of nine (Fig. 157). 

Patrick Cotter, the successor of 
O'Brien, and who for awhile exhibited 
under this name, claiming that he was a 
lineal descendant of the famous Irish 
King, Brian Boru, who he declared was 9 
feet in height, was born in 1761, and 
died in 1806 at the age of forty-five. 
His shoe was 17 inches long, and he was 
8 feet 4 inches tall at his death. 

In the Museum of Madame Tussaud in London there is a wax figure of 
Loushkin, said to be the tallest man of his time. It measures 8 feet 5 
inches, and is dressed in the military uniform of a drum-major of the Im- 
perial Preobrajensky Regiment of Guards. To magnify his height there is 
a figure of the celebrated dwarf, " General Tom Thumb," in the palm of his 
hand. Figure 158 represents a well-known American giant, Ben Hicks, 
who was called '' the Denver Steeple." 

Buffon refers to a Swedish giantess who he affirms was 8 feet 6 inches 
tall. Chang, the " Chinese Giant," whose smiling face is familiar to nearly 

F,g. K 

-Ken Hicks. 


all the modern world, was said to be 8 feet tall. In 1865, at the age of 
nineteen, he nieasnred 7 feet 8 inches. At Hawick, Scotland, in 1870, there 
was an Irishman 7 feet 8 inches in height, 52 inches around the chest, and 
"who weighed 22 stone. Figure 159 shows an American giantess known as 
" Leah, the Giantess." At the age of nineteen she was 7 feet 2 inches tall 
and weighed 165 pounds. 

On June 17, 1871, there were married at Saint-Martins-in-the-Field 
in London Captain Maftin Van Buren Bates of Kentucky and Miss Anna 

Swann of Xova Scotia, two 
celebrated exhibitionists, 
both of whom were over 
7 feet. Captain Bates, 
fiimiliarly known as the 
'' Kentucky Giant," years 
ago was a familiar figure 
in many Xorthern cities, 
where he exhibited him- 
self in company with his 
wife, the combined height 
of the two being greater 
than that of any couple 
known to history. Captain 
Bates W'as born in Whites- 
burg, Letcher County, Ky., 
on November 9, 1845. 
He enlisted in the South- 
ern army in 1861, and 
though only sixteen years 
old was admitted to the 
service because of his size. 
At the close of the war 
Captain Bates had attained 
his great height of 7 feet 
2i^ inches. His body was 
well proportioned and his weight increased until it reached 450 pounds. He 
traveled as a curiosity from 1866 to 1880, being connected with various 
amusement organizations. He visited nearly all the large cities and towns in 
the United States, Canada, Great Britain, France, Spain, Germany, Switzer- 
land, Austria, and Russia. While in England in 1871 the Captain met Miss 
Anna H. Swann, known as the " Nova Scotia Giantess," who was two years the 
junior of her giant lover. ]Miss Swann w^as justly proud of her height, 7 feet 
5 J inches. The two were married soon afterward. Their combined height of 
14 feet 8 inches marked them as the tallest married couple known to mankind. 

Fig. 159.—" Leah, the Giantess. 


DWARFS. 33a 

Captcain Bates' parents were of medium size. His father, a native of 
Virginia, was 5 feet 10 inches high and weighed 160 pounds. His mother 
was 5 feet 3 inches tall and weighed 125 pounds. The height of the father 
of Mrs. Anna Swann Bates was 6 feet and her mother was 5 feet and 2 inches 
high, weigliing but 100 pounds. 

A recent newspaper dispatch says : " Captain M. V. Bates, whose 
remarkable height at one time attracted the attention of the world, has 
recently retired from his conspicuous position anil lives in comparative 
obscurity on his farm in Guilford, Medina County, O., half a mile east of 

In 1845 there was shown in Paris Joachim Eleiceigui, the Spanish giant, 
who Ayeighed 195 kilograms (429 pounds) and whose hands were 42 cm, 
(16 J inches) long and of great beauty. In 1882 at the Alhambra in 
London there was a giantess by the name of Miss Marian, called the 
" Queen of the Amazons," aged eighteen years, who measured 2.45 meters 
(96| inches). William Campbell, a Scotchman, died at Newcastle in May, 
1878. He was so large that the window of the room in which the deceased 
lay and the brick-work to the level of the floor had to be taken out, in 
order that the coffin might be lowered with block and tackle three stories to 
the ground. On January 27, 1887, a Greek, although a Turkish subject, 
recently died of phthisis in Simferopol. He was 7 feet 8 inches in height 
and slept on three beds laid close together. 

Giants of History. — A number of persons of great height, particularly 
sovereigns and warriors, are well-known characters of history, viz., William 
of Scotland, Edward III., Godefroy of Bouillon, Philip the Long, Fairflix, 
Moncey, Mortier, Kleber ; there are others celebrated in modern times. 
Rochester, the favorite of Charles II.; Pothier, the jurist; Bank, the English 
naturalist ; Gall, Billat-Savarin, Benjamin Constant, the painter David, Bel- 
lart, the geographer Delamarche, and Care, the founder of the Gentleman's 
Magazine, were all men of extraordinary stature. 

Dwarfs. — The word " dwarf" is of Saxon origin (dwerg, dweorg) and 
corresponds to the " pumilio " or "nanus" of the Romans. The Greeks 
believed in the pygmy people of Thrace and Pliny speaks of the Spitha- 
miens. In the " Iliad " Homer writes of the pygmies and Juvenal also de- 
scribes them ; but the fantasies of these poets have given these creatures 
such diminutive stature that they have deprived the traditions of credence. 
Herodotus relates that in the deserts of Lybia there were people of extreme 
shortness of stature. The Bible ^ mentions that no dwarf can officiate at the 
altar. Aristotle and Philostratus speak of pygmy people descended from 
Pygmseus, son of Dorus. In the seventeenth century van Helmont supposed 
that there were pygmies in the Canary Islands, and Abyssinia, Brazil, and 
Japan in the older times were repeatedly said to contain pygmy races. Relics 

a Lev. xxi., 20. 


of what must have been a pygmy race have been found in the Hebrides, and 
in this country in Kentucky and Tennessee. 

Dr. Schweinfurth, the distinguished African traveler, confirms the state- 
ments of Homer, Herodotus, and Aristotle that there was a race of pygmies 
near the source of the Nile. Schweinfurth says that they live south of the 
country occupied by the Niam-Niam, and that their stature varies from 4 
feet to 4 feet 10 inches. These people are called the Akkas, and wonderful 
tales are told of their agility and cunning, characteristics that seem to com- 
pensate for their small stature. 

In 1860 Paul DuChaillu speaks of the existence of an African people 
called the Obongos, inhabiting the country of the Ashangos, a little to the 
south of the equator, who were about 1.4 meters in height. There have been 
people found in the Esquimaux region of very diminutive stature. Battel 
discovered another pygmy people near the Obongo who are called the Dongos. 
KoUe describes the Kenkobs, who are but 3 to 4 feet high, and another tribe 
called the Reebas, who vary from 3 to 5 feet in height. The Portuguese speak 
of a race of dwarfs whom they call the Bakka-bakka, and of the Yogas, who 
inhabit territory as far as the Loango. Nubia has a tribe of dw^arfs called 
the Sukus, but little is known of them. Throughout India there are stories 
of dwarf tribes descended from the monkey-God, or Hoonuman of the myth- 
ologic poems. 

In the works of Humboldt and Burgoa there is allusion to the tradition 
of a race of pygmies in the unexplored region of Chiapas near the Isthmus 
of Tehuantepec in Central America. There is an expedition of anthropolo- 
gists now on the way to discover this people. Professor Starr of Chicago 
on his return from this region reported many colonies of undersized people, 
but did not discover any pygmy tribes answering to the older legendary de- 
scriptions. Figure 160 represents two dwarf Cottas measuring 3 feet 6 
inches in height. 

The African pygmies who were sent to the King of Italy and shown in 
Rome resembled the pygmy travelers of Akka that Schweinfurth saw at 
the court of King ]Munza at ]Monbuttu. These two pygmies at Rome were 
found in Central Africa and were respectively about ten and fifteen years 
old. They spoke a dialect of their own and ditferent from any known 
African tongue ; they were partly understood by an Egyptian sergeant, a 
native of Soudan, who accompanied them as the sole survivor of the escort 
with which their donor, ]\Iiani, penetrated Monbuttu. Miaui, like Living- 
stone, lost his life in African travel. These dwarfs had grown rapidly in 
recent years and at the time of report measured 1.15 and 1.02 meters. In 
1874 they were under the care of the Royal Geographical Society of Italy. 
They were intelligent in their manner, but resented being lionized too much, 
and were prone to scratch ladies who attempted to kiss them.'* 

a 476, 1874, i., 896. 



The "Aztec Children" in 1851, at the ages of seven and six years, an- 
other pair of alleged indigenous pygmies, measured 33f and 29 J inches in 
height and weighed 20| and 17 pounds respectively. The circumference of 
their heads did not equal that of an ordinary infant at birth. 

It is known that at one time the ancients artificially produced dwarfs 

I'ig. ICO. — Dwarf C'ottas. 

by giving them an insufficient alimentation when very young. They soon 
became rachitic from their deprivation of lime-salts and a great number 
perished, but those who survived were very highly prized by the Roman 
Emperors for their grotesque appearance. There were various recipes foi 
dwarfing children. One of the most efficient in the olden times was said to 


have been anointing tlie backbone Avith the grease of bats, moles, dormice, 
and snch animals ; it was also said that puppies were dwarfed by frequently 
washing the feet and backbone, as the consequent drying and hardening of 
the parts were alleged to hinder their extension. To-day the growth of boys 
intended to be jockeys is kept down by excessive sweating. 

Ancient Popularity of Dwarfs. — At one time a dwarf was a necessary 
appendage of every noble family. The Koman Emperors all had their 
dwarfs. Julia, the niece of Augustus, had a couple of dwarfs, Conopas 
and Andromeda, each of whom was 2 feet 4 inches in height. It was the 
fashion at one time to have d^varfs noted for their wit and wisdom. Philos 
of Cos, tutor of Ptolemy Philadelphus, was a dwarf, as were Carachus, the 
friend of Saladin ; Alypius of Alexandria, who was only 2 feet high ; Lucinus 
Calvus, who was only 3 feet high, and ^sop, the famous Greek fabulist. 
Later in the ^Middle Ages and even to the last century dwarfs were seen at 
every Court. Lady Montagu describes the dwarfs at the Viennese Court as 
" devils bedaubed with diamonds." They had succeeded the Court Jester 
and exercised some parts of this ancient office. At this time the English 
ladies kept monkeys for their amusement. The Court dwarfs were allowed 
unlimited freedom of speech, and in order to get at truths other men were 
afraid to utter one of the Kings of Denmark made one of his dwarfs Prime 

Charles IX. in 1572 had nine dAvarfs, of which four had been given to him 
by King Sigismund-Augustus of Poland and three by Maximilian II. of 
Germany. Catherine de Medicis had three couples of dwarfs at one time, 
and in 1579 she had still five pygmies, named Merlin, Mandricart, Pelavine, 
Rodomont, and Majoski. Probably the last dwarf in the Court of France 
was Balthazar Simon, who died in 1662. 

Sometimes many dwarfs were present at great and noble gatherings. In 
Rome in 1566 the Cardinal Vitelli gave a sumptuous banquet at which 
the table-attendants were 34 dwarfs. Peter the Great of Russia had a 
passion for dwarfs, and in 1710 gave a great celebration in honor of the mar- 
riage of his favorite, Valakoif, with the dwarf of the Princess Prescovie 
Theodorovna. There were 72 dwarfs of both sexes present to form the 
bridal party. Subsequently, on account of dangerous and difficult labor, 
such marriages were forbidden in Russia. 

In England and in Spain the nobles had the portraits of their dwarfs 
painted by the celebrated artists of the day. Velasquez has represented Don 
Antonio el Ingles, a dwarf of fine appearance, with a large dog, probably to 
bring out the dwarf's inferior height. This artist also painted a great num- 
ber of other dwarfs at the Court of Spain, and in one of his paintings he 
portrays the Infanta Marguerite accompanied by her male and female dwarfs. 
Reproductions of these portraits have been given by Garnier.'^ In the pic- 
a " Les Nains et les Geants." Paris, 1884. 


tures of Raphael, Paul Veronese, and Dominiquin, and in the '' Triumph of 
Csesar" by Mantegna, representations of dwarfs are found, as well as in 
other earlier pictures representing Court events. At the present time only 
Russia and Turkey seem to have popular sympathy for dwarfs, and this in a 
limited degree. 

Intellectual Dwarfs. — It must be remarked, however, that many of the 
dwarfs before the pul)lic have been men of extraordinary intelligence, possi- 
bly augmented by comparison. In a postmortem discussed at a meeting of 
the Natural History Society at Bonn in 18G8 it was demonstrated by 
Schauf hausen that in a dwarf subject the brain weighed -^ of the body, in 
contradistinction to the average proportion of adults, from 1 to 30 to 1 
to 44. The subject was a dwarf of sixty-one who died in Coblentz, 
and was said to have grown after his thirtieth year. His height was 2 feet 
10 inches and his weight 45 pounds. The circumference of the head was 
520 mm. and the brain weighed 1183.33 gm. and was well convoluted. 
This case was one of simple arrest of development, affecting all the organs 
of the body ; he was not virile. He was a child of large parents ; had two 
brothers and a sister of ordinary size and two brothers dwarfs, one 5 inches 
higher and the other his size. 

Several personages famous in history have been dwarfs. Attila, the his- 
torian Procopius, Gregory of Tours, Pepin le Brcf, Charles III., King of 
Naples, and Albert the Grand were dwarfs. About the middle of the seven- 
teenth century the French episcopacy possessed among its meml)ers a dwarf 
renowned for his intelligence. This diminutive man, called Godeau, made 
such a success in literature that by the grace of Richelieu he was named the 
Archbishop of Grasse. He died in 1(572. The Dutch painter Doos, the 
English painter Gibson (who was about 3 feet in height and the father of 
nine infints by a wife of about the same height), Prince Eugene, and the 
Spanish Admiral Gravina were dwarfs. Fleury and Garry, the actors ; 
Hay, a member of Parliament from Sussex in the last century ; Hussein- 
Pasha, celebrated for his reforms under Selim III. ; the Danish antiquarian 
and voyager, Arendt, and Baron Denon were men far below the average size. 
Varro says that there were two gentlemen of Rome who from their decorations 
must have belonged to an Equestrian Order, and who were but 2 Roman cubits 
(about 3 feet) high. Pliny also speaks of them as preserved in their coffins. 

It may be remarked that perhaps certain women are predisposed to 
give birth to dwarfs. Borwilaski had a brother and a sister who were 
dwarfs. In the middle of the seventeenth century a woman brought forth 
four dwarfs, and in the eighteenth century a dwarf named Hopkins had a 
sister as small as he was. Therese Souvray, the dwarf fiancee of Bebe, had 
a dwarf sister 41 inches high. A^irey has examined a German dwarf of eight 
who was only 18 inches tall, /. e., about the length of a newly-born infant. 
The parents were of ordinary size, but had another child who was also a dwarf. 


There are two species of dwarfs, the first coming into the world under 
normal conditions, but who in their infancy become afflicted with a sudden 
arrest of development provoked by some malady ; the second are born very 
small, develop little, and are really dwarfs from their birth ; as a rule they 
are well conformed, robust, and intelligent. These two species can be dis- 
tinguished by an important characteristic. The rachitic dwarfs of the first 
class are incapable of perpetuating their species, while those of the second 
category have proved more than once their virility. A certain number of 
dwarfs have married with women of normal height and have had several 
children, though this is not, it is true, an indisputable proof of their generative 
faculties ; but we have instances in which dwarfs have married dwarfs and 
had a family sometimes quite numerous. Robert Skinner (25 inches) and 
Judith (26 inches), his wife, had 14 infants, well formed, robust, and of 
normal height. 

Celebrated Dwarfs. — Instances of some of the most celebrated dwarfs 
will be cited with a short descriptive mention of points of interest in their 
lives :— 

Vladislas Cubitas, who was King of Poland in 1305, was a dwarf, and 
was noted for his intelligence, courage, and as a good soldier. Geoffrey 
Hudson, the most celebrated English dwarf, was born at Oakham in England 
in 1619. ' At the age of eight, when not much over a foot high, he was pre- 
sented to Henriette Marie, wife of Charles I., in a pie ; he afterward became 
her favorite. Until he was thirty he was said to be not more than 1 8 inches 
high, Avhen he suddenly increased to about 45 inches. In his youth he 
fought several duels, one with a turkey cock, which is celebrated in the verse 
of Davenant. He became a popular and graceful courtier, and proved his 
bravery and allegiance to his sovereign by assuming connnand of a royalist 
company and doing good service therein. Both in moral and physical capaci- 
ties he showed his superiority. At one time he was sent to France to secure 
a midwife for the Queen, who was a Frenchwoman. He afterward chal- 
lenged a gentleman by the name of Croft to fight a duel, and would accept 
only deadly weapons ; he shot his adversary in the chest ; the quarrel 
grew out of his resentment of ridicule of his diminutive size. He was 
accused of participation in the Papist Plot and imprisoned by his political 
enemies in the Gate House at Westminster, where he died in 1682 at the 
advanced age of sixty-three. In Scott's " Peveril of the Peak " Hudson 
figures prominently. This author seemed fond of dwarfs. 

About the same epoch Charles I. had a page in his court named Eicli- 
ard Gibson, who was remarkable for his diminutive size and his ability as a 
miniature painter. This little artist espoused another of his class, Anne 
Shepherd, a dwarf of Queen Henriette INIarie, about his size (45 inches). Mis- 
tress Gibson bore nine children, five of whom arrived at adtilt age and were 
of ordinary proportions. She died at the age of eighty ; her husband after- 


ward became the drawing master of Princesses Mary and Anne, daughters 
of James II.; he died July 23, 1690, aged seventy-five years. 

In 1730 there was born of poor fisher parents at Jelst a child named 
Wybrand Lokes. He became a very skilful jeweler, and though he was of 
diminutive stature he married a woman of medium height, by whom he had 
several children. He was one of the smallest men ever exhibited, meas- 
uring but 25 J inches in height. To support his family better, he abandoned 
his trade and with great success exhibited himself throughout Holland and 
England. After having amassed a great fortune he returned to his country, 
where he died in 1800, aged seventy. He was very intelligent, and proved 
his power of paternity, especially by one son, who at twenty -three was 5 feet 
3 inches tall, and robust. 

Another celebrated dwarf was Nicolas Ferry, otherwise known as Bebe. 
He was born at Plaine in the Vosges in 1741 ; he was but 22 cm. (8 J 
inches) long, weighed 14 ounces at birth, and was carried on a plate to 
the church for baptism. At five Bebe was presented to King Stanislas of 
Poland. At fifteen he measured 29 inches. He was of good constitution, 
but was almost an idiot ; for exam]:)le, he did not recognize his mother after 
fifteen days' separation. He was quite lax in his morals, and exhibited no 
evidences of good nature except his lively attachment for his royal master, 
who was himself a detestable character. He died at twenty -two in a very 
decrepit condition, and his skeleton is preserved in the Museum of Natural 
History in Paris. Shortly before his death Bebe became engaged to a female 
dwarf named Therese Souvray, who at one time was exhibited in Paris at 
the Theatre Conti, together with an older sister. Therese lived to l)e seventy- 
three, and both she and her sister measured only 30 inches in height. She 
died in 1819. 

Aldrovandus ^^"^ 'gives a picture of a fiimous dwarf of the Due de Crequi 
who was only 30 inches tall, though perfectly formed ; he also speaks of 
some dwarfs who were not over 2 feet high. 

There was a Polish gentleman named Joseph Borwilaski, born in 1739, 
who was famed all over Europe. He became quite a scholar, speaking French 
and German fairly well. In 1860, at the age of twenty-two, and 28 inches 
in height, he married a woman of ordinary stature, who bore him two infants 
well conformed. He was exhibited in many countries, and finally settled at 
Durham, England, where he died in 1837 at the almost incredible age of 
ninety-eight, and is buried by the side of the Falstaffian Stephen Kemble. 
Mary Jones of Shropshire, a dwarf 32 inches tall and much deformed, died 
in 1773 at the age of one hundred. These two instances are striking ex- 
amples of great age in dwarfs and are therefore of much interest. Bor- 
wilaski's parents were tall in stature and three of his brothers were small ; 
three of the other children measured 5 feet 6 inches. Diderot has written a 
history of this familv. 


Richeborg,^-^ a dwarf only 23 inches iii height, died in Paris in 1858 
aged ninety years. In childhood he had been a servant in the House of 
Orleans and afterward became their pensioner. During the Revolution he 
passed in and out of Paris as an infant in a nurse's arms, thus carrying 
dispatches memorized Avhich might have proved dangerous to carry in any 
other manner. 

At St. Philip's, Birmingliam, there is the following inscription on a 
tomb : " In memory of ^Nlannetta Stocker, who quitted this life on the 4th 
day of May, 1819, at the age of thirty-nine years, the smallest woman in the 

kingdom, and one of the most 
accomplished." She was born 
in Krauma, in the north of 
Austria, under normal con- 
ditions. Her growth stopped 
at the age of four, M'hen she 
was 33 inches tall. She was 
shown in many villages and 
cities over Europe and Great 
Britain ; she was very gay, 
played well on the piano, and 
had divers other accomplish- 

In 1742 there was shown 
in London a dwarf by the 
name of Robert Skinner, .63 
meters in height, and his wife, 
Judith, ^vho was a little larger. 
Their exhibition was a great 
success and they amassed a 
small fortune ; during twenty- 
three years they had 14 
robust and well-formed chil- 
dren. Judith died in 1763, 
and Robert grieved so much after her that he himself ex})iretl two years later. 
Figure 161 shows a female dwarf with her husband and child, all of 
whom were exhibited some years since in the Eastern United States. The 
likeness of the child to the mother is already noticeable. 

BufFon speaks of dwarfs 24, 21, and 18 inches high, and mentions one 
individual, aged thirty-seven, only 16 inches tall, whom he considers the 
smallest person on record. A^irey in 1818 speaks of an English child of 
eight or nine who was but 18 inches tall. It had the intelligence of a child 
of three or four ; its dentition was delayed until it was tAvo years old and it 
did not walk until four. The parents of this child were of ordinary stature. 

Fig. 161. — Female dwarf with lier liusbaml aud child. 



At the " Cosmorama " iu Regent Street in 1848^ there was a Dutch 
boy of ten exhibited. He was said to be the son of an apothecary and at the 
time of his birth weighed nine pounds. He continued to grow for six months 
and at the expiration of that time weighed 1 2 pounds ; since then, how- 
ever, he had only increased four pounds. The arrest of development seemed 
to be connected with hydrocephalus ; although the head was no larger than 
that of a child of two, the* anterior fontanelle was widely open, indicating 
that there was pressure within. He was strong and muscular ; grave and 
sedate in his manner ; cheer- 
ful and affectionate ; his fP "■ ' I 
manners were polite and en- 
gaging ; he was expert in 
many kinds of handicraft ; 
he possessed an ardent de- 
sire for knowledge and apti- 
tude for education. 

Rawdon '^ described a 
boy of five and a half, at 
the Liverpool Infirmary for 
Children, who weighed 10| 
pounds and whose height 
was 28 or 29 inches. He 
uttered no articulate sound, 
but evidently possessed the 
sense of hearing. His eyes 
were large and well formed, 
but he was apparently blind. 
He suckled, cut his teeth 
normally, but had tonic con- 
tractions of the spine and 
was an apparent idiot. 

Hardie*' mentions a girl 
of sixteen and a half whose 
height was 40 inches and 
weight 35J pounds, includ- 
ing her clothes. During intrauterine life her mother had good health and 
both her parents had always been healthy. She seemed to stop growing at her 
fourth year. Her intellect was on a par with the rest of her body. Some- 
times she would talk and again she would preserve rigid silence for a long 
time. She had a shuffling; walk with a tendencv to move on her toes. Her 
temporary teeth w^ere shed in the usual manner and had been replaced by 
canines and right first molar and incisors on the right side. There was no 

a 476, 1848, ii., 490. b 224, 1879, i., 386. <= 224, 1887, i., 730. 

Fig. 162.— Dwarf, height 34 inches, weight 309 pounds. 


indication of puberty except a slight development of the hips. She was almost 
totally imbecile, but could tell her letters and spell short words. The cir- 
cumference of the head was 1 9 inches, and Ross pointed out that the tendon- 
reflexes were well marked, as well as the ankle-clonus ; he diagnosed the case 
as one of parencephalus. Figure 162 represents a most curious case of a 
dwarf named Carrie Akers, who, though only 34 inches tall, weighed 309 

In recent years several dwarfs have commanded the popular attention, 
but none so much as '' General Tom Thumb," the celebrated dwarf of Bar- 
nuni's Circus. Charles Stratton, surnamed '' Tom Thumb," was born at 
Bridgeport, Conn., on January 11, 1832 ; he above the normal weight 
of the new-born. He ceased growing at about five months, when his height 
was less than 21 inches. Barnum, hearing of this phenomenon in his city, en- 
gaged him, and he was shown all over the world under his assumed name. 
He was presented to Queen A^ictoria in 1844, and in the following year he 
was received by the Royal Family in France. His success was wonderful, 
and even the most conseryative journals described and commented on him. 
He gave concerts, in which he sang in a nasal voice ; but his " dra^\•ing feat " 
was embracing the women who visited him. It is said that in England 
alone he kissed a million females ; he prided himself on his success in this 
function, although his features were anything but inviting. After he had 
received numerous presents and had amassed a large fortune he returned to 
America in 1864, bringing with him three other dwarfs, the "Sisters War- 
ren " and " Commodore Xutt." He married one of the AVarrens, and by 
her had one child, Minnie, who died some months after birth of cerebral con- 
gestion. In 1883 Tom Thumb and his wife, Lavinia, were still living, but 
after that they dropped from public view and have since died. 

In 1895 the wife of a dwarf named Morris gave birth to twins at Blaen- 
avon. North Wales. Morris is only 35 inches in height and his wife is even 
smaller. They were married at Bartholmey Church and have since been 
traveling through England under the name of " General and Mrs. Small," 
being the smallest married couple in the world. At the latest reports the 
mother and her twins were doing well. 

The Rossow Brothers have been recently exhibited to the public. These 
brothers, Franz and Carl, are twenty and eighteen years respectively. 
Franz is the eldest of 16 children and is said to weigh 24 pounds and 
measure 21 inches in height ; Carl is said to weigh less than lys brother but 
is 29 inches tall. They give a clever gymnastic exhibition and are appa- 
rently intelligent. They advertise that they were examined and still re- 
main under the surveillance of the Faculty of Gottingen. 

Next to the success of " Tom Thumb " probably no like attraction has 
been so celebrated as the " I^illiputians," whose antics and wit so many 
Americans have in late years enjoyed. They were a troupe of singers and 



comedians composed entirely of dwarfs ; they exhibited much talent in all 
their performances, which were given for several years and quite recently in 
all the large cities of the United States. They showed themselves to be 
worthy rivals for honors in the class of entertainments known as burlesques. 
As near as could be ascertained, partly from the fact that they all spoke Ger- 
man fluently and originally gave their performance entirely in German, they 
were collected from the German and Austrian Empires. 

The "Princess Topaze" was born near Paris in 1879. According to a 
recent report she is perfectly formed and is intelligent and vivacious. She 
is 23 J inches tall and weighs 14 pounds. Her parents were of normal 

Not long since the papers recorded the death of Lucia Zarete, a Mexican 
girl, whose exact proportions were never definitely known ; but there is no 
doubt that she was the smallest midget 
ever exhibited in this country. Her 
exhibitor made a fortune with her and 
her salary was among the highest paid 
to modern " freaks." 

Miss H. Moritz, an American dwarf 
(Fig. 163), at the age of twenty weighed 
36 pounds and was only 22 inches 

Precocious development is charac- 
terized by a hasty growth of the subject, 
who at an early period of life attains the 
dimensions of an adult. In some of these 
instances the anomaly is associated with 
precocious puberty, and after acquiring 
the adult growth at an early age there 
is an apparent cessation of the devel- 
opment. In adiilt life the individual shows no distinguishing characters. 

The first to be considered will be those cases, sometimes called '*mati- 
boys," characterized by early puljerty and extraordinary development in 
infancy. Histories of remarkable children have been transmitted from the 
time of Vespasian. We read in the " Natural History " of Pliny that in 
Salamis, Euthimedes had a son who grew to 3 Roman cubits (4J feet) in 
three years ; he was said to have little wit, a dull mind, and a slow and 
heavy gait ; his voice was manly, and he died at three of general debility. 
Phlegon^ says that Craterus, the brother of King Antigonus, was an inflmt, 
a young man, a mature man, an old man, and married and begot children 
all in the space of seven years. It is said that King Louis II. of Hungary 
was born so long before his time that he had no skin ; in his second year he 

a "DeMirab.," cap. 32. 

Fig. 1G3.— Dwarf, 22 Inches tall. 


was crowned, in his tenth year he succeeded, in his fourteenth year he had a 
complete l)eard, in his fifteenth he was married, in his eighteenth lie had 
gray hair, and in his t^vcntieth he died. Rhodiginus ^ speaks of a boy who 
when he was ten years impregnated a female. In 1741 there was a boy 
born at AVillingham, near Cambridge,'^ who had the external marks of 
puberty at twelve months, and at the time of his death at five years he had 
the appearance of an old man. He was called "■ prodiginm Willinghamense." 
The Ephemerides and some of the older journals record instances of penile 
erection immediately after birth. 

It was said that Philip Howarth, who was born at Quebec Mews, Port- 
man Square, London, February 21, 1806, lost his infantile rotundity of 
form and feature after the completion of his first year and became pale and 
extremely ugly, appearing like a growing boy. His penis and testes increased 
in size, his voice altered, and hair grew on the pubes. At the age of three 
he was 3 feet 4| inches tall and weighed 51 J pounds. The length of his 
penis when erect was 4J inches and the circumference 4 inches ; his thigh- 
measure was 13| inches, his waist-measure 24 inches, and his biceps 7 inches. 
He was reported to be clever, very strong, and muscular. An old chronicle 
says that in Wisnang Parish, village of Tellurge, near Tygure, in Lordship 
Kiburge, there was born on the 26th of May, 1548, a boy called Henry 
Walker, who at five years was of the height of a boy of fourteen and pos- 
sessed the genitals of a man. He carried burdens, did men's work, and in 
every way assisted his parents, who were of usual size. 

There is a case cited by the older authors '^ of a child born in the 
Jura region who at the age of four gave proof of his virility, at seven had a 
beard and the height of a man. The same journal also speaks of a boy 
of six, 1.62 meters tall, who was perfectly proportioned and had ex- 
traordinary strength. His beard and general appearance, together with the 
marks of pul)erty, gave him the appearance of a man of thirty. 

In 1806 Dupuytren presented to the Medical Society in Paris a child 3|^ 
feet high, weighing 57 pounds, who had attained puberty. 

There are on record six modern eases of early puberty in boys,''''*' one of 
whom died at five with the signs of premature senility ; at one year he had 
shown sio;ns of enlara^ement of the sexual ortjans. There was another who 
at three was 3 feet 6f inches high, weighed 50 pounds, and had seminal dis- 
charges. One of the cases was a child who at birth resembled an ordi- 
nary infant of five months. From four to fifteen months his penis enlarged, 
until at the age of three it measured when erect 3 inches. At this age he 
was 3 feet 7 inches high and weighed 64 pounds. The last case mentioned 
was an infant Avho experienced a change of voice at twelve months and 
showed hair on the pubes. At three years he was 3 feet 4| inches tall and 
weighed 51^ pounds. Smith, in Brewster's Journal, 1829, records the 

a 679, L. viii., cap. 8. ^ 629, 1745. c " Recueil cle PAcademie des Sciences," 1668. 


case of a boy who at the age of four was well developed ; at the age of six 
he was 4 feet 2 inches tall and weighed 74 pounds; his lower extremities 
were extremely short proportionally and his genitals were as well developed 
as those of an adult. He had a short, dark moustache but no hair on his 
chin, although his pubic hair was thick, black, and curly. Ruelle ^ describes 
a child of three and a quarter years who was as strong and muscular as one 
at eight. He had full-sized male organs and long black hair on the pubes. 
Under excitement he discharged semen four or five times a day ; he had a 
deep male voice, and dark, short hair on the cheek and upper lip. 

Stone ^ gives an account of a boy of four who looked like a child of ten 
and exhibited the sexual organs of a man with a luxuriant growth of hair on 
the pubes. This child was said to have been of great beauty and a minia- 
ture model of an athlete. PI is height was 4 feet I inch and weight 70 
pounds ; the penis when semiflaccid was 4^ inches long ; he was intelligent 
and lively, and his back was covered with the acne of puberty. A peculiar 
fact as regards this case was the statement of the father that he himself had 
had sexual indulgence at eight. Stone parallels this case by several otliers 
that he has collected from medical literature. Breschet in 1821 reported 
the case of a boy born October 20, 1817, who at three years and one 
month was 3 feet 6f inches tall ; his penis when flaccid measured 4 inches 
and when erect 5J inches, but the testicles were not developed in pr()i)or- 
tion. Lopez ° describes a mulatto boy of three years ten and a half months 
whose height was 4 feet | inch and weight 82 pounds ; he measured about 
the chest 27| inches and about the waist 27 inches ; his penis at rest was 
4 inches long and had a circumference of 3| inches, although the testes 
Avere not descended. He had evidences of a beard and his axillse were very 
hairy ; it is said he could with ease lift a man weighing 140 pounds. His 
body was covered with acne simplex and had a strong spermatic odor, but 
it was not known whether he had any venereal appetite. 

Johnson '^ mentions a boy of seven with severe gonorrhea complicated 
with buboes which he had contracted from a servant girl with whom he 
slept. At the Hopital des Enfans Malades children at the breast have 
been observed to masturbate. Fournier and others assert having seen infan- 
tile masturbators, and cite a case of a girl of four who w^as habitually 
addicted to masturbation from her infancy but was not detected until her 
fourth year ; she died shortly afterward in a frightful state of marasmus. 
Vogel alludes to a girl of three in whom repeated attacks of epilepsy oc- 
curred after six months' onanism. Van Bambeke mentions three children 
from ten to twenty months old, two of them females, who masturbated. 

Bidwell describes a boy of five years and two months who during the 
year previous had erections and seminal emissions. His voice had changed 
and he had a downy moustache on his upper lip and hair on the pubes ; his 

a 233, Feb. 28, 1843. t) 104^ i852. c 124, 1843. d 476, 1860, i., Feb. 


height was 4 feet o| inches and his weight was 82| pounds. His penis and 
testicles were as well developed as those of a boy of seventeen or eighteen, 
but from his facial aspect one Avould take him to be thirteen. He avoided 
the company of women and would not let his sisters nurse him when he was 

Pry or ^ speaks of a boy of tliree and a half who masturbated and who at 
live and a half had a penis of adult size, hair on the pubes, and was known to 
have had seminal emissions. Woods ^ describes a boy of six years and seven 
months who had the appearance of a youth of eighteen. He was 4 feet 9 inches 
tall and was quite muscular. He first exhibited signs of precocious growth at 
the besinnino; of liis second vear and when three vears old he had hair on the 
pubes. There is an instance ^ in which a boy of thirteen had intercourse with a 
young woman at least a dozen times and succeeded in impregnating her. The 
same journal mentions an instance in which a boy of fourteen succeeded in 
impregnating a girl of the same age. Chevers^^'' speaks of a young boy in 
India avIio was sentenced to one year's imprisonment for raping a girl of three. 

Douo-lass ^ describes a bov of four vears and three months who was 3 feet 
lOi inches tall and weighed 54 pounds ; his features were large and coarse, and 
his penis and testes were of the size of those of an adult. He was unusually 
dull, mentally, quite obstinate, and self-willed. It is said that he masturbated 
on all opportunities and had vigorous erections, although no spermatozoa 
were found in the semen issued. He showed no fondness for the opposite 
sex. The history of this rapid growth says that he was not unlike other 
children until the third year, when after wading in a small stream several 
hours he was taken witli a violent chill, after which his voice began to 
change and his sexual organs to develop. 

Blanc -^"- quotes the case described by Cozanet in 1875 of Louis Beran, 
w^ho was born on September 29, 1869, at Saint-Gervais, of normal size. 
At the age of six months his dimensions and weight increased in an extra- 
ordinary fashion. At the age of six years he was 1.28 meters high (4 feet 2^ 
inches) and Aveighed 80 pounds. His puberty was completely manifested in 
every way ; he eschewed the society of children and helped his parents in 
their labors. Campbell ^ showed a lad of fourteen who had been under his 
observation for ten years. AVhen fifteen months old this prodigy had hair 
on his pubes and his external genitals were abnormally large, and at the age 
of two years they were fully developed and had not materially changed in 
the following years. At times he manifested great sexual excitement. 
Between four and seven years he had seminal discharges, but it was not 
determined Mliether the semen contained spermatozoa. He had the muscular 
development of a man of twenty-five. He had shaved several years. The 
boy's education was defective from his failure to attend school. 

a 778, xxii., 521. b 476, 1882, ii., 377. c 004^ i887, i.. 918. 

d 597, 1889. e 536, No. 2591, 551. 



The accompanying illustration (Fig. 164) represents a boy of five years 
and three months of age whose height at this time was 4 feet and his physical 
development far beyond that usual at this age, his external genitals resembling 
those of a man of twenty. His upper lip was covered by a mustache, and 
the hirsute growth elsewhere was similarly precocious. 

The inscription on the tombstone of James Weir in the Parish of Car- 
luke, Scotland, says that when only thirteen months old he measured 3 feet 
4 inches in height and weighed 5 stone. He was pronounced by the 
faculty of Edinburgh and Glasgow to be 
the most extraordinary child of his age. 
Linnaeus saw a boy at the Amsterdam 
Fair who at the age of three weighed 
98 pounds. In Paris, about 1822, there 
was shown an intant Hercules of seven 
who was more remarkable for obesity 
than general development. He was 3 
feet 4 inches high, 4 feet 5 inches in cir- 
cumference, and weighed 220 pounds. 
He had prominent eyebrows, black eyes, 
and his complexion resembled that of a 
fat cook in the heat. Borellus ^^^ details 
a description of a giant child. There is 
quoted from Boston '^ the report of a boy 
of fifteen months weighing 92 pounds 
who died at Coney Island. He was said 
to have been of phenomenal size from 
infancy and was exhibited in several 
museums during his life. 

Desbois of Paris mentions an extra- 
ordinary instance of rapid growth in a 
boy of eleven who grew 6 inches in fifteen 

Large and Small New-born In- 
fants. — There are many accounts of 
ne^v-born infants who were characterized 
by their diminutive size. On page 66 

we have mentioned Usher's instance of twins born at the one hundred 
and thirty-ninth day weighing each less than 1 1 ounces ; Barker's case of a 
female child at the one hundred and fifty-eighth day weighing 1 pound ; 
Newinton's case of twins at the fifth month, one weighing 1 pound and the 
other 1 pound 3| ounces ; and on page 67 is an account of Eikam's five- 
months' child, weighing 8 ounces. Of full-term children Sir Everard 

a 224, Aug. 31, 1895. 

1 ig. Iii4. — I'roL'Ocious development in a bey of 
five years and three months. 


Home, in his Croonian Oration in 1824,'' speaks of one borne by a woman 
who was traveling with the baggage of the Duke of Wellington's army. 
At her fourth month of pregnancy this woman was attacked and bitten by a 
monkey, but she went to term, and a living child was delivered which 
weighed but a pound and was between 7 and 8 inches long. It was brought 
to England and died at the age of nine, w